Customer Feedback Survey

Purpose: This survey is designed to gather customer feedback on our products and services. Your responses are valuable in helping us improve your customer experience.

Customer Information

Name: {name}
Email: {email}
Phone: {phone}
Purchase Date: {purchaseDate}

Product/Service Details

Product/Service Name: {productName}
Order/Invoice Number: {orderNumber}

Feedback Questions

1. How satisfied are you with the product/service? {satisfactionLevel}
2. What features did you like the most? {likedFeatures}
3. What areas do you think we can improve? {improvements}
4. Would you recommend us to others? {recommendation}

Additional Comments

{additionalComments}

{#followUpConsent}

Consent for Follow-Up

The customer has agreed to be contacted for additional feedback or clarification.

Preferred Contact Method: {preferredContactMethod}

Best Time to Reach: {contactTime}

{/followUpConsent}

{^followUpConsent}

Consent for Follow-Up

The customer has not agreed to be contacted for additional feedback or clarification.

{/followUpConsent}

Summary of Ratings

Service Representatives Involved

{#representatives}

• {name} - {role}, Contact: {contact}

{/representatives}

Thank you for your valuable feedback!