INTERNAL CUSTOMER SATISFACTION SURVEY FORM

Function/Department FOR THE PERIOD Sl.no. 1 2 3 4 5 Attributes Quality of service Adherence to delivery schedule / timeliness completion Response Reaction to queries support during critical situations Others - Specify :

Sl.no Date

: :

Internal Customer:

No.of dissatisfaction events

Total No of Dissatisfaction Events: Sl.no. Event Description Repeated Event (Yes/No)

(HOD-Internal customer) sign & Date