Quality Assurance Survey
Survey Date
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Company Name
Type of industry this company belongs to
Education
Health
Retail
Environment
Business
Government
Other
What are the products and services of the company?
Do you know if the company has an internal quality assurance team?
Please Select
Yes
No
Do you know if the company has an external quality assurance team?
Please Select
Yes
No
Customer Service
Rows
Not Satisfied
Somewhat Satisfied
Satisfied
Very Satisfied
Friendliness
1
2
3
4
Courteous
5
6
7
8
Respectful
9
10
11
12
Oral Communication
13
14
15
16
Verbal Communication
17
18
19
20
Problem-solving skills
21
22
23
24
Empathy
25
26
27
28
Product/Service Knowledge
29
30
31
32
Time Management
33
34
35
36
Patience
37
38
39
40
Feedback/Comments/Suggestions for customer service
Products and services
Rows
Not Satisfied
Somewhat Satisfied
Satisfied
Very Satisfied
Quality
41
42
43
44
Stability
45
46
47
48
Design
49
50
51
52
Theme
53
54
55
56
Intangibility
57
58
59
60
Usability
61
62
63
64
User-friendly
65
66
67
68
Feedback/Comments/Suggestions for products and services
Delivery and Shipping
Rows
Not Satisfied
Somewhat Satisfied
Satisfied
Very Satisfied
Did the product arrive on time?
69
70
71
72
Is the courier respectful?
73
74
75
76
Did the courier call you prior to delivery?
77
78
79
80
Was the expectation met?
81
82
83
84
Feedback/Comments/Suggestions for delivery and shipping
How do you think our products and services can be improved?
Is there a product or service you are not satisfied with? If yes, please explain?
Rate the service
Products and Services
1
2
3
4
5
Customer Service
1
2
3
4
5
Shipping and Delivery
1
2
3
4
5
Overall Rating
1
2
3
4
5
Overall feedback or suggestions
Personal Information
Information about the person who fills up the survey
Name
First Name
Last Name
Phone Number
Format: (000) 000-0000.
Email
example@example.com
Age
Gender
Male
Female
Occupation
Do you want to subscribe to our newsletter that contains updates and promos from our team?
Yes
No
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