Attachment_E-Customer_Feedback_Form.docx
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- W900KK-17-R-0019
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Attachment E-Customer Feedback Form (Draft)
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ATTACHMENT E:
Customer Feedback Form
Date/Time of Service Feedback Originator/Telephone #: ________________________________________ Service(s) Received/Requested:
1.) Nature of complaint or comment:
2.) What is one thing the Contractor could do to improve your level of satisfaction?
Thank you for taking time to assist us in improving the level of service.
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
Remainder of form is for use by the Contractor/COR:
Date/Time Contractor Received Feedback Contract: __________________
Contractor Determination/Explanation: Complaint Valid Complaint Not Valid
(CONTINUE ON REVERSE)
Action Taken by Contractor:
(CONTINUE ON REVERSE)
Contractor Signature: Date:
COR Determination: Complaint Valid Complaint Not Valid Corrective Action Sat Corrective Action Unsat
COR Signature: Date:
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