customer feedback form examples

Client Experience and Feedback Submission Agreement

Instructions for Use

• Complete all bracketed fields to ensure the feedback process is properly documented within your organization's compliance framework.
• Ensure the respondent is provided with a copy of your privacy policy or data processing notice prior to execution.
• Maintain this form in a secure, centralized repository to facilitate periodic review and audit of service quality metrics.

Parties and Definitions

This Feedback Submission Agreement (the "Agreement") is entered into by and between [Company Name], located at [Company Address] ("Company"), and [Full Legal Name], located at [Respondent Address] ("Respondent").

1. Feedback: Refers to any suggestions, comments, ideas, or performance evaluations provided by the Respondent regarding the services or products of the Company.
2. Effective Date: [Date of Submission].

Operative Terms

1. Submission of Feedback: Respondent agrees to provide honest, good-faith feedback concerning the services rendered by the Company. Respondent represents that all statements made are true to the best of their knowledge.

2. Grant of License: Respondent hereby grants to the Company a perpetual, irrevocable, royalty-free, worldwide license to use, reproduce, disclose, and distribute the Feedback for the purposes of quality improvement, internal training, and marketing, provided that the Company adheres to the privacy terms herein.

3. Confidentiality: The Company agrees to handle all personal identifying information (PII) contained within this form in accordance with the [Company Name] Privacy Policy. The Company shall take reasonable measures to protect the identity of the Respondent if requested.

4. No Compensation: Respondent acknowledges that the provision of Feedback is voluntary and that no monetary compensation, credit, or other consideration is due to the Respondent in exchange for the submission.

5. Warranties: Respondent warrants that the Feedback provided does not infringe upon the intellectual property rights of any third party and does not contain defamatory or unlawful content.

6. Governing Law: This Agreement shall be governed by and construed in accordance with the laws of [Jurisdiction/State/Province].

Acknowledgment and Consent

[ ] I consent to the use of my feedback for marketing and promotional purposes. [ ] I request that my feedback remain anonymous in public-facing materials.

Signature: __________ Printed Name: [Full Legal Name] Title: [Respondent Title/Role] Date: [Date]

Legal Disclaimer

This document is a general framework provided for informational purposes only and does not constitute legal advice. You must consult with qualified legal counsel to ensure this document complies with the specific laws and regulations of your jurisdiction, particularly regarding data privacy and consumer protection statutes.