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CUSTOMER FEEDBACK/ COMPLAINT FORM
Dear Customer,
Understanding your expectations will help us to serve you better.
We shall be grateful if you could spare a moment to give us your valuable feedback.
1. Which Branch / Location/ Department/Unit are you commenting on?
2. How satisfied were you with your experience?
Very Satisfied
Satisfied
Not Satisfied
3. If you were not satisfied with our service, could you tell us why? Do you have any complaints with respect to the same?
4. Branch services (If you have not used this service, please skip this section)
Cash Counter / Teller Service (Deposit/Withdrawal/Remittance)
Microfinance Services
5. How would you rate the following at the branch?
A. Speed of service
Very Good
Good Average
Average
Poor
N/A
B. Courtesy of staff
Very Good
Good Average
Average
Poor
N/A
C. Knowledge of staff
Very Good
Good Average
Average
Poor
N/A
D. Adequacy of staff at branch counters
Very Good
Good Average
Average
Poor
N/A
E. Availability of brochures, deposit slips etc.
Very Good
Good Average
Average
Poor
N/A
F. Ambience / cleanliness of branch
Very Good
Good Average
Average
Poor
N/A
G. Ease of locating the required service counter
Very Good
Good Average
Average
Poor
N/A
What could we do to improve our service?
6. ATM Services(If you have not used this service, please skip this section)
How would you rate the following?
A. Convenient location of the ATM
Very Good
Good Average
Average
Poor
N/A
B. Easy to use for all banking services
Very Good
Good Average
Average
Poor
N/A
C. ATM uptimes/ serviceability
Very Good
Good Average
Average
Poor
N/A
D. Cash availability/ denominations
Very Good
Good Average
Average
Poor
N/A
E. Cleanliness of surrounding area
Very Good
Good Average
Average
Poor
N/A
What could we do to improve our service?
7. Loans (If you have not used this service, please skip this section)
Did you visit the branch?
Did our Representative visit you?
How would you rate the following?
A. Manner in which the request was handled
Very Good
Good Average
Average
Poor
N/A
B. Speed of service
Very Good
Good Average
Average
Poor
N/A
C. Knowledge of staff
Very Good
Good Average
Average
Poor
N/A
D. Courtesy of staff
Very Good
Good Average
Average
Poor
N/A
E. Time taken to disburse loan
Very Good
Good Average
Average
Poor
N/A
F. After sales service
Very Good
Good Average
Average
Poor
N/A
What could we do to improve our service?
8. Is there any other matter not covered above on which you would like to give us your feedback?
9. Would you like to give us your name, type of account and contact details? If yes, please rest assured that your response will be treated in the strictest confidence.
Name
Contact Number
E-mail
Type the letters below:
Thank you for your valuable time!
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GM Bank IT department