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Customer card

Clien - Appelation:

City:

Compl. questionare - name:

Office:

Date of completion:

Please rate your satisfaction with the work of our company by checking the boxes corresponding to your evaluation of the recorded parameters below and your assessment of the weight (importance) of the corresponding item.
/ Item 10 and 11 are provided for other indicators that are important in your assessment. /

Assessments must conform to scale your satisfaction indicators:
0 - completely dissatisfied	2 - partially unsatisfied	4 - partially satisfied
6 - satisfied	8 - completely satisfied	10 - extremely satisfied

The weights must comply with the following scale of importance for the corresponding item:

Indicators	Assessment of satisfaction:	Weight Indicator:
1 Quality of the products	0 2 4 6 8 10	1 2 3 4
2 Conformity with the arrangements made	0 2 4 6 8 10	1 2 3 4
3 Compliance with delivery deadlines	0 2 4 6 8 10	1 2 3 4
4 Communic. and respons. of your applicat.	0 2 4 6 8 10	1 2 3 4
5 Information that you receive for products	0 2 4 6 8 10	1 2 3 4
6 And type of packaging supplies	0 2 4 6 8 10	1 2 3 4
7 Prices	0 2 4 6 8 10	1 2 3 4

8	0 2 4 6 8 10	1 2 3 4

9	0 2 4 6 8 10	1 2 3 4

This part should be completed by Unipharm JSC: % of total customer satisfaction: Formula assessment: