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America Diagnostics
Revolutionary Diagnostics Tools
Customer Feedback
Customer Satisfaction Questionnaire
Date of Survey: _______________________
Customer Company Name: ____________________________________________________
Customer Representative Name: _______________________________________________
Answer these questions as simply and directly as possible with a yes, no, or numerical answer. If additional notes are relevant, add them to the notes column on the right.
| Survey Questions | Yes/No | Notes |
| Did ADX products perform as you expected? | ||
| Are there any improvements or expectations you as the customer would like to bring to th attention of ADX? | ||
| Are there any additional products or services you would like ADX to provide? | ||
| Are there any additional questions, concerns, and/or suggestions you would like to indicate to ADX? | ||
| Did you receive your materials on time? | ||
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Additional comments and/or feedback: |
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