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Customer Number:
Name:
1. Overall Performance
<--Poor
Excellent-->
        Does not apply
     • Your Overall Satisfaction
1 2 3 4 5
  • Time taken from Order to Delivery
1 2 3 4 5
  • Adherence to delivery time
1 2 3 4 5
 
2. Performance of Customer Service
<--Poor
Excellent-->
  • Ability to contact a customer service representative     
1 2 3 4 5
  • Attitude and Courtesy
1 2 3 4 5
  • Did we ask for all necessary information?
1 2 3 4 5
  • Did we give you a confirmation number
1 2 3 4 5
 
3. On-line Order Entry
<--Poor
Excellent-->
  • The site was easy to use
1 2 3 4 5
 
4. Delivery Service
<--Poor
Excellent-->
  • Was the courier on time?
1 2 3 4 5
  • Was the courier wearing a uniform?
1 2 3 4 5
  • Attitude of courier
1 2 3 4 5

5. Where did you hear about Urban Express?
  
Salesmen
Newspaper/Magazine  (please specify) 
Internet
Previous Purchase
Corporate Purchasing Dept.   
Direct Mail or Promotion
Other   (please specify) 
6. Comments
 
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