Customer Satisfaction Questionnaire

Dear Client!

We appreciate very much that you are using our products and services. According to our mission “Dedicated to Customer Value” it is our continuous aim to improve the level of our performance. We review therefore the degree of your satisfaction both with our products and services in line with the quality requirements of EN ISO SO 13485 for medical products. Thus, we are asking you to take a few minutes to fill out this questionnaire, make comments and suggestions where appropriate and return it to us by fax.

Tomed Quality Management Thank you very much for your kind cooperation!

GENERAL INFORMATION

Name (company, doctor's office):
Discipline:
Customer-No.:
Address:
Post Code and Town:
Country:
Tel.:
Fax:
E-Mail:
Internet:
Are you certified? Yes No
  ISO 9001 ISO 13485
 Other certificate:
 

Please rate the degree of satisfaction (1=very low; 2=low; 3=medium; 4=high; 5=very high) and assign a value to indicate the grade of relevance for each criterion (1=not important; 2=quite important; 3=important; 4=very important; 5=essential) referring both to our products and services.

Questionnaire

CRITERIA		Satisfaction	Relevance
PRODUCTS	Functionality	1 2 3 4 5	1 2 3 4 5
	Manufacturing quality	1 2 3 4 5	1 2 3 4 5
	Design / Appearance	1 2 3 4 5	1 2 3 4 5
	Range of products	1 2 3 4 5	1 2 3 4 5
	Carton	1 2 3 4 5	1 2 3 4 5
	Grade of innovation	1 2 3 4 5	1 2 3 4 5
	Documentation (instructions, brochures, publications)	1 2 3 4 5	1 2 3 4 5
	(other criterion)	1 2 3 4 5	1 2 3 4 5
	(other criterion)	1 2 3 4 5	1 2 3 4 5

NOTES / SUGGESTIONS

CRITERIA		Satisfaction	Relevance
SERVICE	Kindness of staff	1 2 3 4 5	1 2 3 4 5
	Response to queries & helpdesk service	1 2 3 4 5	1 2 3 4 5
	Speed of delivery	1 2 3 4 5	1 2 3 4 5
	Clearness of administrative documents such as (proforma-) invoices and shipping documents	1 2 3 4 5	1 2 3 4 5
	Observance of delivery terms	1 2 3 4 5	1 2 3 4 5
	Quality of delivery (packaging and condition of goods on arrival)	1 2 3 4 5	1 2 3 4 5
	Technical complaint handling (speed, quality of problem resolution)	1 2 3 4 5	1 2 3 4 5
	Administrative complaint handling (e.g. invoices, incorrectly supplied goods)	1 2 3 4 5	1 2 3 4 5
	Competitive price policy	1 2 3 4 5	1 2 3 4 5
	Avertising in medical jounals	1 2 3 4 5	1 2 3 4 5
	Exhibiting at medical congresses and fairs	1 2 3 4 5	1 2 3 4 5
	Web Site – Quality of information and updating	1 2 3 4 5	1 2 3 4 5
	(other criterion)	1 2 3 4 5	1 2 3 4 5
	(other criterion)	1 2 3 4 5	1 2 3 4 5

NOTES / SUGGESTIONS