Service Evaluation Form

Service Evaluation Questionnaire

We would appreciate a few minutes of your time,
to help us improve our level of service by filling in this service evaluation form.

Name: Extension:

1. Our record shows that you requested service on
at

2. Description of Service/Location:

3. The service or repair was completed on
at

4. Was the repair time acceptable to you?

5. Was the response time acceptable to you?

6. Did the mechanic fix the problem to your satisfaction?

7. Did the mechanic leave the working area neat and clean:Yes No

8. Did the mechanic answer your questions satisfactorily?

9. If not, did the mechanic refer you to another person? Yes No

Would you describe the situation?

10. Which of the following best describes the mechanic's performance?

Excellent Very Good Good Poor Unacceptable

11. Are there any suggestions for improving our services?

Shop/Area
Service Order Number
FMD Employee

114 S. Buchanan Blvd. Durham NC 27701 - Phone:919-660-4222 - Work Control Center at 684-2122