Online Retail Delivery Satisfaction Assessment
Please provide your feedback about your recent delivery experience to help us improve our service.
Order Reference Number
*
Full Name
*
First Name
Last Name
Email Address (optional, for follow-up if needed)
example@example.com
Date of Delivery
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
How would you rate the overall delivery experience?
*
1
2
3
4
5
Was your package delivered on time?
*
Yes
No
Please rate the following aspects of your delivery experience:
*
Rows
Excellent
Good
Average
Poor
Condition of package
1
2
3
4
Friendliness of delivery personnel
5
6
7
8
Communication about delivery status
9
10
11
12
Ease of rescheduling or tracking
13
14
15
16
Handling of special instructions
17
18
19
20
What was the condition of your package upon arrival?
*
Perfect condition
Slightly damaged packaging, items fine
Damaged packaging, items fine
Damaged packaging and items
Other
Which of the following best describes your delivery? (Select all that apply)
*
Delivered to doorstep
Handed to me personally
Left at a designated location
Required signature upon delivery
Other
Would you recommend our delivery service to others?
*
Definitely
Probably
Not sure
Probably not
Definitely not
Additional comments or suggestions
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