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Customer Feedback Form
Reported by: Date:
Customer:  
Customer Contact: Phone:
Cause: Returned (defective or inoperable) product
Missed delivery schedule
Product performance


Description:
Disposition:
Action taken to prevent recurrence:


Disposition Completed:
Department Manager: Date:


Disposition Verified:
Quality Assurance Manager: Date:


Customer Contacted:
Department Manager: Date:


Final Review:
Department Manager: Date:


CAR #:
Form: GCP3-2F1



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