Is an electronic signature legally binding?

Yes. Under the ESIGN Act and related state law, electronic signatures satisfy signature requirements when intent, consent, attribution, and reliable record retention are present. See 15 U.S.C. §7001 and the Uniform Electronic Transactions Act where adopted; exceptions apply for wills and certain court orders.

Do I need HIPAA protections for client responses?

If feedback contains protected health information, implement HIPAA safeguards and execute a Business Associate Agreement before collecting electronically. Retain related records at least six years per 45 CFR §164.530(j) and restrict access consistent with privacy policies.

When is notarization or witness required?

Notarization or witnesses are rarely required for routine feedback forms. If a signed response functions as formal contractual acceptance affecting deeds, powers of attorney, or other document types, consult state law; requirements vary by jurisdiction and document type.

How long should completed questionnaires be retained?

Retention depends on content: tax or billing records follow IRC §6501(a) (minimum three years), HIPAA records six years under 45 CFR §164.530(j), and some industries or contracts require seven or more years. Check state variations before disposal.

What if a client changes their submitted response?

Treat an update as a new, timestamped record. Preserve the original, record the change reason and author, and require reauthorization if prior acceptance is being rescinded to maintain evidentiary integrity for disputes.

Who is authorized to sign the questionnaire?

Authorized signers are individuals with authority under the governing contract or corporate delegation. Verify printed name, title, and role; for organizations, attach proof of authority such as a corporate resolution when required.

Electronic Signature
Templates
Miscellaneous
Client Feedback ESR Questionnaire

Client Feedback ESR Questionnaire

This template is fully customizable. Edit the text, fill out the fields, and send it for signature. Give it a try!

Client Feedback ESR Questionnaire

Parties and Recitals

This Client Feedback ESR Questionnaire and Agreement (the Agreement) is entered into by the parties identified below to record client feedback, confirm scope of services, and set limited binding terms related to the ESR feedback and any supplemental services arising from it.

Client Name:

Service Provider Name:

ESR Reference Number: Date of Feedback:

WHEREAS

WHEREAS, Service Provider has delivered services to Client pursuant to prior agreement(s) and Client has completed or is completing the Engagement Services Review (ESR); and

WHEREAS, the parties wish to record Client feedback, identify corrective actions or enhancements, and document limited commercial terms related to any follow-on services resulting from the ESR.

Scope of Work

Describe the services covered by this ESR and any proposed follow-on work:

Payment Terms (If follow-on services are agreed)

Estimated Amount: Payment Schedule: Late Payment Fee:

Term and Termination

Term Start Date: Term End Date:

Either party may terminate any agreed follow-on services by providing written notice at least days prior to the intended termination date. Termination shall not relieve Client of obligations to pay for work performed to the date of termination in accordance with the Payment Terms above.

Confidentiality

Each party agrees to keep confidential all proprietary or non-public information disclosed in connection with the ESR and any follow-on work. Confidential information excludes information that is (a) already in the public domain through no fault of the receiving party, (b) rightfully received from a third party without restriction, or (c) independently developed. The receiving party shall use confidential information solely for purposes of performing or evaluating the services and shall not disclose it to third parties without prior written consent except as required by law.

Feedback Questionnaire — Ratings

Instructions: For each item below, select a rating where 5 = Excellent, 1 = Poor. Provide optional comments where indicated.

Overall Satisfaction

5 4 3 2 1

Communication

5 4 3 2 1

Timeliness

5 4 3 2 1

Quality of Deliverables

5 4 3 2 1

Value for Money

5 4 3 2 1

Open Comments and Recommendations

Please provide any further comments, specific recommendations, or corrective actions you request: May Service Provider use anonymized excerpts of this feedback for internal improvement or marketing purposes?

I consent to use anonymized excerpts of my feedback.

Governing Law and Entire Agreement

Governing Law: This Agreement shall be governed by and construed in accordance with the laws agreed by the parties below. Any dispute arising under or in connection with this Agreement shall be subject to the exclusive jurisdiction of the courts agreed by the parties.

Entire Agreement: This Questionnaire and Agreement constitutes the entire agreement between the parties with respect to the subject matter herein and supersedes all prior understandings, proposals, or agreements, whether written or oral, relating to the ESR feedback and any limited follow-on services described. Any amendment must be in writing and signed by authorized representatives of both parties.

Acknowledgment and Certification

By signing below, the undersigned certify that the feedback provided in this Questionnaire is truthful to the best of their knowledge, that they are authorized to provide such feedback on behalf of the Client, and that they understand and accept the limited contractual provisions set forth in this Agreement regarding confidentiality, payment (if applicable), and use of feedback.

Client Name:

By:

Date:

Service Provider Name:

By:

Date:

What the Client Feedback ESR Questionnaire Is and why it matters

The Client Feedback ESR Questionnaire is a structured form organizations use to gather consistent client evaluations of services, deliverables, and support. It combines quantitative rating scales, open narrative fields, and essential metadata (project reference, dates, and responder role) so responses can be linked to contracts and workflows. The ESR label denotes an evidence‑standard approach intended to produce auditable feedback that supports quality reviews, regulatory checks, and dispute resolution while preserving a clear record for retention and reporting purposes.

How a standardized questionnaire improves client feedback

A consistent Client Feedback ESR Questionnaire reduces interpretation risk, produces comparable metrics across engagements, and preserves documented client acceptance for compliance and contract management while simplifying internal analysis and remediation planning.

Who completes and uses questionnaire results

Clients, account managers, and project leads commonly complete or distribute the questionnaire during closeout or scheduled service reviews.

Clients or authorized representatives who experienced the service provide ratings and narrative feedback.
Account managers distribute the questionnaire and verify project identifiers and response completeness.
Quality, compliance, and sales teams analyze aggregated responses for improvements and contractual evidence.

Aggregated responses are used by quality, compliance, and sales teams to track trends, validate acceptance, and inform process improvements.

Primary sections included in a professional ESR questionnaire

A professional questionnaire groups client metadata, rating scales, narrative responses, compliance checkpoints, follow‑up actions, and signature fields to ensure completeness and auditability.

Metadata

Collect client name, company, contact details, project or contract reference, service dates, and responder role to link feedback to records and enable follow‑up without ambiguous identifiers.

Ratings

Use numeric or Likert‑style scales for service quality, timeliness, communication, and overall satisfaction; include clear scale anchors and require at least one quantitative field per section.

Narrative

Provide open‑ended prompts for strengths, concerns, and specific incidents; instruct respondents to reference dates and deliverable identifiers to make qualitative feedback actionable and include contact details for follow‑up.

Compliance Checks

Include yes/no confirmations for acceptance criteria, regulatory acknowledgements, and data privacy consent where required; track fields that may affect billing or contractual acceptance and attach supporting documents when applicable.

Follow‑up

Specify recommended next steps, assigned owner, and target completion dates for remedial actions or improvements, and include a checkbox if the client requests contact for clarification.

Signature

Provide signature block with printed name, title, date, and electronic signature field; note whether the signature constitutes formal acceptance under the governing contract and include retention instructions for the executed form.

Stepwise process to collect and finalize feedback

Follow these sequential steps to collect, verify, and finalize client feedback for auditability and integration with contract records.

01

Prepare: Identify recipient, project reference, and required fields.
02

Send: Distribute via secure link or email with instructions.
03

Confirm: Validate required fields and contact details before closing.
04

Record: Store executed copy and populate CRM or records.

Configure questionnaire workflow and field behavior

Configure an online questionnaire with required fields, conditional logic, automated routing, and optional signer authentication before distribution.

Field	Configuration \| Example
Required Fields	Make fields mandatory \| Client name, rating
Conditional Logic	Show/hide fields based on answers \| Escalate if low rating
Authentication	Email or SMS code \| SMS 2FA recommended
Routing	Sequential or parallel approval \| Account manager notified

Delivery channels, formats, and integration needs

Choose delivery channels that meet client accessibility and authentication requirements, including integrations and file format support.

Formats: PDF, DOCX, and flattened PDF output
Integrations: CRM, storage, and project systems
Authentication: Email link, SMS code, or SSO

Typical eSubmission flow from authoring to archive

Typical online workflow moves documents from authoring through signer authentication, signing, automated distribution, and archival with audit trail capture.

Upload: Upload template and configure fields.
Invite: Send signer link or email with optional authentication.
Sign: Signer reviews and signs on device.
Complete: System issues signed copy and audit record.

Recommended internal timelines and response windows

Set clear internal deadlines for distribution, response, review, retention, and statutory timelines to ensure compliance and timely remediation.

Distribution to client:

Within 5 business days of service completion.

Requested response window:

Typical 10–15 business days for completion.

Internal review period:

3–5 business days after receipt.

Retention start date:

Effective date or signature date begins retention clock.

Escalation if no response:

Escalate after 20 business days to account manager.

Common mistakes to avoid when preparing questionnaires

Omitting project or contract reference prevents matching feedback to deliverables, causes manual reconciliation, and may void the response's usefulness for acceptance or billing decisions.
Using unclear rating anchors or mixed scales leads to inconsistent data and undermines comparative analysis across clients and time periods.
Collecting personal health information without HIPAA considerations or a signed BAA risks noncompliance and legal exposure in healthcare contexts.
Failing to validate contact details prevents automated notifications and can delay remedial actions or contract dispute resolution.

Potential penalties and legal risks from incorrect handling

Data Privacy: HIPAA breach fines, contractual liability

Missing TIN: Triggers 24% backup withholding

Late Reporting: Penalties under IRC §6721

Invalid Acceptance: Disputed acceptance may void charge

I-9 Risk: Paperwork fines $281–$2,789

Reputational: Lost trust and business impact

Security and compliance considerations for electronic questionnaires

In Transit: TLS 1.2/1.3 encryption

At Rest: AES‑256 encrypted data at rest

Certifications: SOC 2 Type II; ISO 27001

HIPAA: BAA available for PHI

eSign Law: ESIGN and UETA compliant

Audit Trail: Detailed timestamps, IP and logs

eSignature pricing and feature comparison for questionnaire distribution

Comparing common eSignature vendors can clarify cost, compliance, and volume limits when choosing a platform for questionnaire distribution.

	signNow	DocuSign	Adobe Sign	PandaDoc	HelloSign
Starting Price	$8/user/mo	$15/user/mo	$14/user/mo	$19/user/mo	$15/user/mo
Free Trial	7-day free trial	Varies by vendor	Varies by vendor	Varies by vendor	Varies by vendor
Bulk Send	Yes	Varies by plan	Varies by plan	Varies by plan	Varies by plan
Audit Trail	Yes	Yes	Yes	Yes	Yes
HIPAA Compliant	Yes	Yes	Yes	No	No

Real‑world examples of questionnaire adoption

These examples illustrate how organizations use standardized feedback forms to improve turnaround, compliance, and recordkeeping.

Optica Ventures — Brian Fitzgibbons

Optica Ventures used the questionnaire to standardize client feedback across portfolios, improving response consistency and traceability.

The interface is simple and easy-to-use for our team.
Standardized reporting allowed the firm to link responses to projects, reduce follow‑up time, and provide auditable acceptance records for portfolio reporting and contract closeouts.

Fertility Centers of Illinois — John Butler

Fertility Centers of Illinois integrated the questionnaire with internal systems to capture signed client confirmations and automate archival.

The airSlate SignNow team has been exceptional, responsive.
Integration reduced manual processing, ensured signed acceptance attached to client records, and improved the team's ability to produce audit trails for regulatory review and internal quality tracking.

Frequently asked questions about completion, signing, and retention

Common questions about completing, signing, and retaining the Client Feedback ESR Questionnaire are answered below to reduce errors and legal uncertainty.

Need help? Contact support

Is an electronic signature legally binding?
Yes. Under the ESIGN Act and related state law, electronic signatures satisfy signature requirements when intent, consent, attribution, and reliable record retention are present. See 15 U.S.C. §7001 and the Uniform Electronic Transactions Act where adopted; exceptions apply for wills and certain court orders.
Do I need HIPAA protections for client responses?
If feedback contains protected health information, implement HIPAA safeguards and execute a Business Associate Agreement before collecting electronically. Retain related records at least six years per 45 CFR §164.530(j) and restrict access consistent with privacy policies.
When is notarization or witness required?
Notarization or witnesses are rarely required for routine feedback forms. If a signed response functions as formal contractual acceptance affecting deeds, powers of attorney, or other document types, consult state law; requirements vary by jurisdiction and document type.
How long should completed questionnaires be retained?
Retention depends on content: tax or billing records follow IRC §6501(a) (minimum three years), HIPAA records six years under 45 CFR §164.530(j), and some industries or contracts require seven or more years. Check state variations before disposal.
What if a client changes their submitted response?
Treat an update as a new, timestamped record. Preserve the original, record the change reason and author, and require reauthorization if prior acceptance is being rescinded to maintain evidentiary integrity for disputes.
Who is authorized to sign the questionnaire?
Authorized signers are individuals with authority under the governing contract or corporate delegation. Verify printed name, title, and role; for organizations, attach proof of authority such as a corporate resolution when required.

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