Customer Satisfaction Survey

Dear customer,
Thank you for agreeing to take a few moments to complete this simple product and service quality survey. UGACO will use your response along with others we receive to help insure we are continually listening and learning from our clients.

Your contribution is greatly appreciated.

Please select the appropriate response for each of the five items below.
An additional area is available for any other comments you may have.

» Customer Name (Company)

» Contact Person

Email

City

State

Zip

» Required Field

Please rate your satisfaction with United Gear on the following:
	Excellent	Very Good	Good	Satisfactory	Poor
Quality of Product	1	2	3	4	5
On-Time Delivery	1	2	3	4	5
Customer Service	1	2	3	4	5
Administrative Order & Invoice Accuracy	1	2	3	4	5
Overall Satisfaction	1	2	3	4	5

Additional Comments/Suggestions

Please include any additional information related to making United Gears products and service better.