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Customer Feedback Form

Post-purchase or post-service feedback collection with rating scales and open-ended questions

Customer Feedback Form
Customer name and order/service reference number
Date of purchase or service
Overall satisfaction rating (1-5 stars)
Product/service quality rating
Customer service experience rating
Value for money rating
Likelihood to recommend (NPS question)
What did we do well? (open text)
What could we improve? (open text)
Permission to use feedback as testimonial
Signature
Date

Structured customer feedback form with clearly labeled fields.

Form Fields

  • Customer name and order/service reference number
  • Date of purchase or service
  • Overall satisfaction rating (1-5 stars)
  • Product/service quality rating
  • Customer service experience rating
  • Value for money rating
  • Likelihood to recommend (NPS question)
  • What did we do well? (open text)
  • What could we improve? (open text)
  • Permission to use feedback as testimonial

Clean layout with adequate space for handwritten or typed responses. Required fields clearly marked. Signature and date lines at bottom.

Customize fields, add your organization header, and make fillable in PDFb2.

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