Customer P.O. Satisfaction Survey

Please take a few moments to evaluate the product(s) and service(s) you have received from Ledford Gage Lab, Inc. so that we may serve you better in the future.  Please fax this form back to 316-777-2220 or email us with your comments at

Did you receive your item(s) by your requested or required date?	Y	N
Comments:
Were your special instructions or requests followed adequately?	Y	N
Comments:
Were your items received in good condition? (packaging)	Y	N
Comments:
Do our test certificates contain adequate information?	Y	N
Comments:
When contacted by our personnel, were they friendly and helpful?	Y	N
Comments:

Your overall satisfaction with your order?
Very satisfied   Satisfied   Somewhat satisfied
Not satisfied   Very dissatisfied
Comments:


Anything else you’d like us to know to help us serve you better?

Reference information:
Company Name:
Person Completing Form:
Title:
Email:
Purchase Order No.:
Date:

Thank you for your time!