CUSTOMER ASSESSMENT FORM
Customer Name*:
Customer Number:
Ship To:
Customer Contact*:
Date:
Month
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Day
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2007
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2010
Please rate each of the following on a scale from 1 (poor) to 5 (excellent):
1. What is your overall appraisal of Merit's quality of part? (select one)
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1
2
3
4
5
2. What is your appraisal of our fill rates and overall service capabilities? (select one)
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1
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3
4
5
3. How do you rate our Customer Service/Inside Sales Support on their response time to estimates/quotations? (select one)
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1
2
3
4
5
4. How do you rate our Customer Service/Inside Sales Support on their response time to order processing? (select one)
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1
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3
4
5
5. How do you rate our on-time delivery? (check one)
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5
6. How do you rate our packaging and shipping? (check one)
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1
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5
7. Comments:
