Fluid Web Solutions
Central Industries: Customer Feedback Form
Please complete this brief form so we can better serve you in the future.
Name
*
First
Last
Title/Position
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Company
*
Phone Number
*
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Email
*
Account Number
Order Number
Please rate the following
*
Excellent
Very Good
Good
Needs Improvement
Quality of Product
1
2
3
4
Customer Service
1
2
3
4
Helpfulness of Sales Rep.
1
2
3
4
Delivery Time
1
2
3
4
Packaging
1
2
3
4
Additional Information or Comments
Do Not Fill This Out