Customer Feedback Form

Machine #:

Machine Number/Subcontractor Company

Operator Name:

Operator Name

Shareholder or Sub-Contractors Machinery:

Shareholder OperatorHired OperatorSub-ContractorUnknown

Shareholder or Subbie

Date Of Discussion:

Customer Company:

Company Name

Customer Name:

First & Last Name of Customer supplying feedback

Customer Contact Phone:

Customer Phone

Email:

Contact Email for follow up

Summary of Feedback Area:

Summary of Feedback

Details of Feedback:

Feedback Details

Outcome Summary:

Outcome Supplied

Allocators Summary of Outcome:

Allocators Summary of Outcome