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Questions marked with an * are required Exit Survey
 
 
* Service Offering: Commercial
 
Installation
 
Servicing
 
 
 
* Company:
 
City Cas
 
Kindly
 
SHH
 
Cementmix
 
 
 
* Name of Staff:
   
 
 
 
* Date of Service Encounter:
 
 
 
* Time of Service Encounter:
Hrs.Mins.AM/PM
  
 
 
 
* Name of Customer:
   
 
 
 
* Location:
   
 
 
 
* Job Number:
   
 
 
PROFESSIONAL
Please indicate your level of agreement towards the following statements:
 
 
* The staff was courteous throughout the service encounter (e.g. greet and thank, was not rude)
 
Strongly Disagree
 
Disagree
 
Agree
 
Strongly Agree
 
Not Applicable
 
 
Comments (for disagreement ratings and N/A):
   
 
 
* The staff portrays a professional image (e.g. identified himself, dressed appropriately in City Gas uniform, carried proper work tools)
 
Strongly Disagree
 
Disagree
 
Agree
 
Strongly Agree
 
Not Applicable
 
 
Comments (for disagreement ratings and N/A):
   
 
 
* The staff was clear in his communications during the service encounter (e.g. spoke clearly, audible)
 
Strongly Disagree
 
Disagree
 
Agree
 
Strongly Agree
 
Not Applicable
 
 
Comments (for disagreement ratings and N/A):
   
 
 
RELATIONSHIP BUILDER
Please indicate your level of agreement towards the following statements:
 
 
* The staff made effort to build rapport with me (e.g. made small talk, explained work procedures)
 
Strongly Disagree
 
Disagree
 
Agree
 
Strongly Agree
 
Not Applicable
 
 
Comments (for disagreement ratings and N/A):
   
 
 
* The staff was attentive and patient to understand and answer my queries
 
Strongly Disagree
 
Disagree
 
Agree
 
Strongly Agree
 
Not Applicable
 
 
Comments (for disagreement ratings and N/A):
   
 
 
* The staff listened to my problems / feedback patiently
 
Strongly Disagree
 
Disagree
 
Agree
 
Strongly Agree
 
Not Applicable
 
 
Comments (for disagreement ratings and N/A):
   
 
 
 
INITIATIVE
Please indicate your level of agreement towards the following statements:
 
 
* The staff was proactive to explain check status
 
Strongly Disagree
 
Disagree
 
Agree
 
Strongly Agree
 
Not Applicable
 
 
Comments (for disagreement ratings and N/A):
   
 
 
 
* The staff was helpful and suggested solutions / alternatives
 
Strongly Disagree
 
Disagree
 
Agree
 
Strongly Agree
 
Not Applicable
 
 
Comments (for disagreement ratings and N/A):
   
 
 
* The staff made effort to minimise any inconvenience
 
Strongly Disagree
 
Disagree
 
Agree
 
Strongly Agree
 
Not Applicable
 
 
Comments (for disagreement ratings and N/A):
   
 
 
 
DEPENDABLE
Please indicate your level of agreement towards the following statements:
 
 
* I am assured of the quality of work delivered by the staff
 
Strongly Disagree
 
Disagree
 
Agree
 
Strongly Agree
 
Not Applicable
 
 
Comments (for disagreement ratings and N/A):
   
 
 
 
* The staff made me feel safe when he was carrying out the task
 
Strongly Disagree
 
Disagree
 
Agree
 
Strongly Agree
 
Not Applicable
 
 
Comments (for disagreement ratings and N/A):
   
 
 
* The staff provided adequate safety precautions and information clearly to me
 
Strongly Disagree
 
Disagree
 
Agree
 
Strongly Agree
 
Not Applicable
 
 
Comments (for disagreement ratings and N/A):
   
 
 
 
EFFICIENCY
Please indicate your level of agreement towards the following statements:
 
 
* The job was completed within my expected timeframe
 
Strongly Disagree
 
Disagree
 
Agree
 
Strongly Agree
 
Not Applicable
 
 
Comments (for disagreement ratings and N/A):
   
 
 
* The staff addressed my problem appropriately and satisfactorily
 
Strongly Disagree
 
Disagree
 
Agree
 
Strongly Agree
 
Not Applicable
 
 
Comments (for disagreement ratings and N/A):
   
 
 
 
OVERALL SATISFACTION
Please indicate your level of agreement towards the following statements:
 
 
 
* Overall, I am satisfied with the level of service provided by City Gas' staff
 
Strongly Disagree
 
Disagree
 
Agree
 
Strongly Agree
 
 
* Why?
   
 
 
* What is the one thing that the service staff can do to improve your experience?
   
 
 
* Any other feedback / comments?
   
 
 
 
Interviewer Name: