Customer Satisfaction Survey

Customer Satisfaction Survey

Question Title

* 1. During your most recent interaction, office staff treated you with courtesy and respect.

Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

Question Title

* 2. Overall, how responsive has the Diabetes Store Inc. been to your questions or concerns about our service?

Extremely responsive

Very responsive

Somewhat responsive

Not so responsive

Not at all responsive

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* 3. If you receive supplies, are your supplies delivered in a timely manner?

Always

Usually

Sometimes

Rarely

Never

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* 4. Overall, how would you rate the Diabetes Store Inc.?

Far above average

Above average

Average

Below average

Far below average

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* 5. How likely are you to recommend the Diabetes Store Inc. to others?

Very likely

Likely

Neither likely nor unlikely

Unlikely

Very unlikely

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* 6. Referral Source: How did you hear about us?

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* 7. Is there anything we can do to service you better?

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* 8. Is there any additional information about your experience that you would like to share?

Question Title

* 9. Provide Contact Information

Name *

Email Address

Phone Number *