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Customer Satisfaction Questionnaire Dear Community Partner: We would greatly appreciate your feedback regarding your satisfaction regarding this recently delivered project. Please complete this form and return it to the EPICS Program Coordinator, Pam Brown, at the address below. Your specific responses will be kept confidential, but general information will be used to help us to better meet your needs and to educate the teams on how to better serve the community through their projects. Community Organization:____________________________________________ Project:_____________________________ Delivered on:____________ Primary community contact for this project:______________________________ Completed by (if different from above):__________________________________ 1. What were the project’s objectives that you expected the team to accomplish? 2. Approximately what percentage of the design objectives do you think the design team achieved? 3. On a scale of 1 – 5, how close was the final outcome to your initial expectations? 1 2 3 4 5 Significantly Met Significantly below Above 4. How beneficial do you anticipate this project to be for your organization? 1 2 3 4 5 Not very Somewhat Very beneficial beneficial beneficial 5. How would you rate the quality of communication between the design team and you or your organization during the project? 1 2 3 4 5 Very poor Poor Adequate Very good Excellent Please return to Pam Brown, EPICS Program Coordinator, 701 W. Stadium Avenue, West Lafayette, IN 47907-2045; email: firstname.lastname@example.org; fax 765-494-0052. Adapted from CSQ developed by D. K. Sobek II and V. K. Jain. Customer Satisfaction Questionnaire 6. Please rate your satisfaction with the project in the following areas: Very Somewhat Very dissatisfied satisfied satisfied 1 2 3 4 5 a. Quality of appearance of project b.Quality of user manuals and troubleshooting guides c. Timeliness of completion of project d.Attention to safety e. Attention to project user needs f. Maintainability g.Overall project h.Quality of delivery of project itself i. Follow-up by students after delivery 7. How well have the maintenance and upkeep roles of EPICS and project partner identified? 1 2 3 4 5 Not addressed Adequately Very clearly by team addressed by team identified by team Any additional comments: ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ Please return to Pam Brown, EPICS Program Coordinator, 701 W. Stadium Avenue, West Lafayette, IN 47907-2045; email: email@example.com; fax 765-494-0052. Adapted from CSQ developed by D. K. Sobek II and V. K. Jain.
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