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Customer Visitation Report Form
Please fill the form below
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Step 3
Please let us know how we are doing for you
*
Location Name:
This field is required.Please enter value
*
Email id:
This field is required.Please enter value
*
Sales representative:
Anthony
Margaret
Ann
Angelo
Mike C
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*
Type of Visit:
Good will
Followup
Issue
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Next
*
Today's Date:
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Date format is invalid, please check it again
The value must be greater than or equal to -21474836487
The value must be less than or equal to 2147483647
*
Location:
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*
Contact person name:
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*
Quality of Products:
Excellent
Good
Average
Dissatisfied
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Quality notes for production to see:
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Route Representative :
Excellent
Good
Average
Dissatisfied
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Timliness of Delivery:
Excellent
Good
Average
Dissatisfied
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Notes about Delivery:
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Invoicing & Billing:
Excellent
Good
Average
Dissatisfied
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Notes about Delivery:
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Order Accuracy:
Excellent
Good
Average
Dissatisfied
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Notes about Delivery:
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Value:
Excellent
Good
Average
Dissatisfied
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Overall Experience:
Excellent
Good
Average
Dissatisfied
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How often do you wish to be visited:
Monthly
Every quarter
Every 6 months
Once a year
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Payment type:
Cash on delivery
Credit card
Debit card
Gpay
Paytm
Phonepay
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Next Visit :
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Date format is invalid, please check it again
The value must be greater than or equal to -21474836487
The value must be less than or equal to 2147483647
Photo:
(?)
Selected file is Invalid. (only file type .jpg,.png,.gif and 5 MB size allowed)
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Comments/Suggestions:
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Signature:
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