Sample Customer Satisfaction Survey Tool

Go Back to the Beginning

Please check the box to the left of the term that best describes your feelings about services from [Your Organization].

All things considered, the experience of doing business with [Your Organization] is:

 

Delightful

 

Positive

 

Somewhat Positive

 

Unpleasant

 

Terrible

 

Less than Positive

Overall, was the service you recently purchased from [Your Organization]:

 

Better than you expected

 

About what you expected

 

Not quite what you expected

 

Not at all what you expected

Please comment:

___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________

How satisfied were you with the overall value of the service you received from [Your Organization]:

 

It was great!

 

Good solid value

 

Something of a let down

 

Very disappointing

 

Overall, how satisfied are you with the service you received from [Your Organization]:

 

I love it!

 

I’m pleased

 

I’m disappointed

 

I thought it was awful

 

Compared to all other places from which you receive services, [Your Organization] is:

 

Much better to do business with

 

Somewhat better to do business with

 

Somewhat worse to do business with

 

Much worse to do business with

 

Please comment:
___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________

Would you recommend services from [Your Organization] to a friend?

 

Definitely

 

Probably

 

Probably Not

 

Definitely Not

If you could deliver a message directly to the president of [Your Organization], what would you want him/her to know about your experience with [Your Organization]?
___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________

How could [Your Organization] improve its services to provide you with greater value?
___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________

Concerning your recent service from [Your Organization], was this:

 Your first purchase from [Your Organization]
 Not your first purchase from [Your Organization]

How long have you been receiving such services from this organization:

 

3 years or less

 

4 to 9 years

 

10 to 15 years

 

16 to 25 years

 More than 25 years

  

OPTIONAL

Your Name ________________________________________________________

Your Company _____________________________________________________

Address __________________________________________________________

Telephone Number ________________________________________

 

Gittomer, p. 98 talks about using a WOW Report Card to determine how satisfied your customers are with your service. He says that you should look for the following reactions from your customers that will tell you that they believe you are WOW (give great service)!

  • Getting WOW comments on the spot
  • Getting (earning) a smile from the person you are helping.
  • Hearing "I can't thank you enough," or "I don't know how to thank you."
  • Getting personal invitations from your customers for sporting events, parties, etc.
  • Hearing "One of your customers was telling me about you and had very nice things to say about you. "WOW!"
  • A letter from a customer you WOWed!
  • Repeat business from the customer you WOWed.
  • A referred customer from someone you WOWed.

Getting all W's is being and doing WOW consistently. The absence of WOW is a report card also.

Using a focus group approach is often a good way of determining how customers like doing business with an organization. It’s a great way of involving customers. Typically a focus group consists of groups of 10-12 customers. A time of 1 and ½ hours is spent in asking the group general questions about the strengths and weakness of the organization. Then the leader focuses in on one special area of interest by asking ten (10) questions about the services provided (these questions could be taken directly from a written survey tool). The questions could be about their experiences with staff. Questions such as:

 Did you feel comfortable talking with us?
 Did we know our business or our service?
 Did our staff call you within 2 weeks to be sure our service was okay?

Reilly asks what he terms power questions to determine customer satisfaction. They are as follows:

 How strongly would you consider coming to this place for service again?
 Would you enthusiastically recommend to a close friend or associate that they
 come here for services?
 To how many people in the past year have you recommended this organization?
 If you could make your recent service choice over again, would you still come to
  this place for service?

In conclusion, it is a good idea to give the focus group some sort of gift as they leave as a nice way of thanking them for donating their time and demonstrating their interest. A gift certificate to a local restaurant is always a nice gesture. The bottom line in assessing customer satisfaction is to serve your customers well by understanding them deeply. Do use surveys and other tools to determine how pleased they are, but don’t rely on them completely. They are simply no substitute for what is called “breathing customer air” meaning being out there where your customers are so you can continually ask them how you and your organization are doing to meet their needs. As we complete this part of our program, I would like to leave you with some parting thoughts about customers:


        “If you’re not serving the customer, your job is to be serving someone who is.”

                 Jan Carizon
                 Former CEO, SAS

        Rule 1: The customer is always right!
        Rule 2: If the customer is ever wrong, reread Rule 1

                 Stew Leonard’s Dairy Store
                 Norwalk, Connecticut

        Customer expectations of service organizations are loud and clear : look good, be responsive, be reassuring by being courteous and competent, be empathetic but, most of all be reliable. Do what you said you would do!

                 Dr. Leonard Berry
                 Researcher, Texas A&M University

        Despite all of the untold millions of products and services for sale today, customers will exchange their hard-earned money for only two things:

        • Good feelings
        • Solutions to problems (including their health problems) So…

        Don't sell me things. Sell me ideals, feelings, self- respect, a good home life, and happiness. (LeBoeuf, p. 23)


healthcare education nursing ce ceus contact hours medical terminology documentation nursing education, continuing education, ceus, contact hours, cne, cme, nurse training, staff development