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Questionnaire Design: Non-scannable Survey

Sample Format for Non-Scannable Survey

QUALITY OF SERVICE SURVEY
FOR XYZ COMPANY

Please rate your experience with our company for each of the statements listed below. (Please circle only one answer for each statement.) Strongly
Agree
Tend To
Agree
Tend To
Disagree
Strongly
Disagree
1. The sales representative demonstrated a comprehensive knowledge of XYZ's products and services.

1 2 3 4
2. XYZ's service representatives are competent, courteous, and knowledgeable.

1 2 3 4
3. XYZ's Customer Service Center personnel are competent, courteous, and knowledgeable.

1 2 3 4
4. We have been properly instructed in the use of our system.

1 2 3 4
5. Whenever commitments are made by XYZ personnel, they are kept or we are promptly informed of a rescheduled commitment.

1 2 3 4
6. XYZ's invoices are clear and invoicing procedures are satisfactory.

1 2 3 4
7. Telephone calls to XYZ are answered timely and courteously, and are immediately transferred to an individual who can service our needs.

1 2 3 4

8. Taking everything into consideration, how satisfied are you with our company as a provider of service?

COMPLETELY
SATISFIED
SATISFIED SOMEWHAT
DISSATISFIED
VERY
DISSATISFIED

9. How likely is it that you would recommend our company to someone you know?
VERY
LIKELY
LIKELY SOMEWHAT
UNLIKELY
NOT VERY
LIKELY

10. What type of services do you foresee your company needing in the next twelve moths?



11. How many times in the last year have you called on our company for service or information? ________

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Superior DataWorks, LLC
340 Poplar View Ln East, Ste. 1
Collierville, TN 38017
Phone: 901.861.6301 / Fax: 901.861.6302