DOC # DCL/QA/CST/001

DEWAN
ISSUE DATE 01-01-16
REVISION # 001
CEMENT LIMITED REVISION DATE -
PAGE # 01

CUSTOMER FEEDBACK FORM DATE S. NO.

SECTION A: GENERAL INFORMATION

COMPANY NAME & ADDRESS

CONTACT PERSON TYPE OF CUSTOMER

TELEPHONE #

EMAIL ADDRESS LOCAL CLIENT

DATE OF DISPATCH

MODE OF DELIVERY FOREIGN CLIENT

QUANTITY

BRAND

DELIVERY ORDER #

SECTION B: FEEDBACK
Kindly tick the selection which applies (1 for extremely dissatisfied/extremely unlikely, 5 for highly satisfied/highly likely)

1. WERE YOU SATISFIED WITH THE DELIVERY TIME 1 2 3 4 5

2. WERE YOU SATISFIED BY THE QUALITY OF THE PRODUCT 1 2 3 4 5

3. WERE YOU SATISFIED BY THE QUALITY OF THE 1 2 3 4 5

PACKAGING

4. WOULD YOU RECOMMEND THIS PRODUCT TO OTHERS 1 2 3 4 5

5. HOW LIKELY ARE YOU TO BUY THIS PRODUCT AGAIN IN 1 2 3 4 5

THE FUTURE

6. WERE YOU SATISFIED BY OUR AFTER-SALES SERVISES 1 2 3 4 5

7. DID YOU FIND OUR PRODUCT PRICING COMPETITIVE 1 2 3 4 5

1 2 3 4 5
8. HOW EFFECTIVE WAS OUR COMMUNICATION DURING
NEGOTIATION

9. WERE OUR INVOICES TIMELY AND EFFECTIVE 1 2 3 4 5

 DOC # DCL/QA/CST/001

DEWAN
ISSUE DATE 01-01-16
REVISION # 001
CEMENT LIMITED REVISION DATE -
PAGE # 02

ARE THERE ANY PRODUCTS OR SERVICES YOU WANT US TO OFFER IN ADDITION?

COMMENTS/ SUGGESTIONS

SECTION C: FOR OFFICE USE ONLY

RECEIVED BY SECTION HEAD DEPARTMENT HEAD

NAME: NAME: NAME:

SIG: SIG: SIG: