CUSTOMER FEEDBACK FORM   Thank you for being a customer. Please help us improve our product and our service to you by completing this survey.   Please rate your level of satisfaction with your sales representative in the following areas:     Responsiveness Very satisfied Somewhat satisfied Neither satisfied nor dissatisfied     Professionalism Very satisfied Somewhat satisfied Neither satisfied nor dissatisfied     Understanding of my needs Very satisfied Somewhat satisfied Neither satisfied nor dissatisfied     How satisfied are you with the following characteristics of our product?     Quality Very satisfied Somewhat satisfied Neither satisfied nor dissatisfied     Price Very satisfied Somewhat satisfied Neither satisfied nor dissatisfied     Promo (if any) Very satisfied Somewhat satisfied Neither satisfied nor dissatisfied How would you likely rate our service?     Accounting and Collections Excellent Very Good Good Poor Very Poor     Deliver Service Excellent Very Good Good Poor Very Poor     After Sales Customer Service Excellent Very Good Good Poor Very Poor     Over-all Purchase Experience Excellent Very Good Good Poor Very Poor Additional comments and suggestions?         Please complete the following information:     Name     Title     Company     Date