Below is the  Quality Scale Surveytemplate body. If necessary, please put the personal information, company information, such as text to replace the specific content you need. you can download the .doc template file on the end of the article by click download link. 

QUALITY SCALE SURVEY

Name:   
Age:   
Gender:   

1
Poor

2
Fair

3
Good

4
Very Good

5
Excellent



For each item identified below, circle the number to the right that best fits your judgment of its quality.  Use the scale above to select the quality number. 

Description / Identification of Survey Item
Scale

Insert an Item Description or leave blank
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5

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5

Insert an Item Description or leave blank
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5

Insert an Item Description or leave blank
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5

Insert an Item Description or leave blank
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5

Insert an Item Description or leave blank
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5

Insert an Item Description or leave blank
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5

Insert an Item Description or leave blank
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5

Insert an Item Description or leave blank
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5

Insert an Item Description or leave blank
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5

Insert an Item Description or leave blank
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5

Insert an Item Description or leave blank
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click to download Quality Scale Survey template
                            

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