Continuous Improvement & Benchmarking

Customer survey template
Customer survey to ascertain the level of satisfaction with the xxxxxxxxxxx service.
For each of the following aspects of Council’s xxxxxxxxxxxx service, please firstly rate the importance of that aspect, then rate the performance of our service.

Importance
Not applicabl e / Don’t know

Our Performance
Ver y Hig h Ver y Lo w Lo w Neit her Hig h nor Low Hig h Ver y Hig h

Ver y Lo w

Lo w

Neit her High nor Low

Hig h

At the time the service is xxxxxxxxxxxxxx
NA NA NA

1 1 1

2 2 2

3 3 3

4 4 4

5 5 5

1 1 1

2 2 2

3 3 3

4 4 4

5 5 5

At the time the xxxxxxxxxxxxx
NA NA NA NA NA

1 1 1 1 1

2 2 2 2 2

3 3 3 3 3

4 4 4 4 4

5 5 5 5 5

1 1 1 1 1

2 2 2 2 2

3 3 3 3 3

4 4 4 4 4

5 5 5 5 5

At the time the xxxxxxxxxxx
NA NA

1 1

2 2

3 3

4 4

5 5

1 1

2 2

3 3

4 4

5 5

At the time the xxxxxxxxx
NA NA NA NA

1 1 1 1

2 2 2 2

3 3 3 3

4 4 4 4

5 5 5 5

1 1 1 1

2 2 2 2

3 3 3 3

4 4 4 4

5 5 5 5

124054617.doc

Created: 21-Dec-04

Revised: 14-Mar-05

© 2004 ADB Institute

1 of 4

Continuous Improvement & Benchmarking Importance
Not applicabl e / Don’t know

Our Performance
Ver y Hig h Ver y Lo w Lo w Neit her Hig h nor Low Hig h Ver y Hig h

Ver y Lo w

Lo w

Neit her High nor Low

Hig h

Within the week following the xxxxxxxxxxxxx
NA NA

1 1

2 2

3 3

4 4

5 5

1 1

2 2

3 3

4 4

5 5

At the time of xxxxxxxxxxxxxx
NA NA NA NA NA NA

1 1 1 1 1 1

2 2 2 2 2 2

3 3 3 3 3 3

4 4 4 4 4 4

5 5 5 5 5 5

1 1 1 1 1 1

2 2 2 2 2 2

3 3 3 3 3 3

4 4 4 4 4 4

5 5 5 5 5 5

At the time xxxxxxxxxxxxxx
NA NA NA NA NA NA NA NA

1 1 1 1 1 1 1 1

2 2 2 2 2 2 2 2

3 3 3 3 3 3 3 3

4 4 4 4 4 4 4 4

5 5 5 5 5 5 5 5

1 1 1 1 1 1 1 1

2 2 2 2 2 2 2 2

3 3 3 3 3 3 3 3

4 4 4 4 4 4 4 4

5 5 5 5 5 5 5 5

At the time xxxxxxxxxx
NA NA NA

1 1 1

2 2 2

3 3 3

4 4 4

5 5 5

1 1 1

2 2 2

3 3 3

4 4 4

5 5 5

Overall satisfaction with Council’s xxxxxxxxxxxx service.
124054617.doc Created: 21-Dec-04

NA

1

2

3

4

5

1

2

3

4

5

Revised: 14-Mar-05

© 2004 ADB Institute

2 of 4

Continuous Improvement & Benchmarking If you rated our performance as Low or Very Low for any aspect, please tell us why:

(Optional) Name: -------------------------------------------Contact phone: ----------------------------------

124054617.doc

Created: 21-Dec-04

Revised: 14-Mar-05

© 2004 ADB Institute

3 of 4

Continuous Improvement & Benchmarking
Disclaimer: The views expressed in this Toolkit are the views of the authors and do not necessarily reflect the views or policies of the Asian Development Bank (ADB) or Asian Development Bank Institute (ADBI), or their Board of Directors, or the governments they represent. ADB and ADBI do not guarantee the accuracy of the data included in this CD-ROM and accepts no responsibility for any consequences of their use. Terminology used may not necessarily be consistent with ADB official terms.

124054617.doc

Created: 21-Dec-04

Revised: 14-Mar-05

© 2004 ADB Institute

4 of 4

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