Delivery Assessment Service Acknowledgement Form
Please complete this form to provide your feedback on the delivery service and acknowledge your participation.
Your Name
*
First Name
Last Name
Date of Delivery
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Overall, how would you rate the delivery service?
*
1
2
3
4
5
Please rate the following aspects of the delivery:
*
Rows
Excellent
Good
Fair
Poor
Timeliness
1
2
3
4
Condition of Package
5
6
7
8
Professionalism of Delivery Person
9
10
11
12
Communication/Updates
13
14
15
16
Was the delivery completed as expected?
*
Yes
No
How likely are you to recommend our delivery service to others?
*
Not likely
1
2
3
4
5
6
7
8
9
Very likely
10
1 is Not likely, 10 is Very likely
Please share any additional comments or suggestions.
Submit Assessment
Should be Empty: