Can this form be e-signed?

Yes — electronic signatures are generally enforceable under the ESIGN Act (15 U.S.C. §7001) and UETA where adopted, provided intent, consent, attribution, and retention requirements are met. Exceptions include wills, court orders, and certain notices where electronic signing is prohibited.

What makes an e-signature valid?

Validity requires demonstrating signer intent, consenting to electronic transactions (ESIGN consumer disclosure for consumer-facing records), reliable attribution of the signature to the signer, and retention/reproducibility of the record. Audit trails, timestamps, and authentication strengthen the legal presumption of validity.

Is notarization or witness required?

Not normally for internal rating forms, but state rules vary for documents affecting title or legal status. Remote online notarization is permitted in most states with identity proofing and recording requirements; check state notary commission for specific RON rules.

How long should these records be kept?

Keep active records for the life of the account plus at least three years; financial or tax-linked records follow IRC §6501(a) minimums, and healthcare records with PHI require six years under 45 CFR §164.530(j). State laws may require longer retention.

Can I collect PHI on this form?

You may collect PHI only when necessary and with proper authorization; platforms must support HIPAA-compliant workflows and a signed BAA. Retain PHI records for six years and apply access controls and encryption (45 CFR §164.530(j)).

What are common errors to avoid?

Common errors include inconsistent rating scales, missing reviewer identity or date, lack of signer consent for electronic records, failure to retain audit trails, and storing PHI without HIPAA protections; correct these to preserve enforceability and auditability.

Electronic Signature
Templates
Miscellaneous
Customer Rating Information Form

Customer Rating Information Form

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

Customer Rating Information Form

RECITALS

This Customer Rating Information Form (the "Form") is entered into between Company Name: and Customer/Reviewer Name: .

WHEREAS, the Company provides products and/or services to customers and seeks structured feedback to evaluate performance and customer satisfaction; and

WHEREAS, the Customer/Reviewer has agreed to provide a rating and related information under the terms and conditions set forth in this Form to assist the Company in assessing service quality and maintaining records.

CUSTOMER INFORMATION

Customer Name Contact Information (email / phone) Mailing Address Relationship to Company

SCOPE OF RATING

The Customer/Reviewer will evaluate the Company's performance with respect to the goods or services received during the applicable engagement period. Describe the specific product(s) or service(s) being rated and any parameters to be considered below.

RATING CRITERIA

Use the numeric scale where 1 = Poor, 2 = Fair, 3 = Good, 4 = Very Good, 5 = Excellent. Enter a single integer value for each criterion.

Quality of Product/Service Timeliness / Delivery Communication & Responsiveness Value for Money Overall Rating Additional Comments Publication & Use

Permission to publish aggregate or excerpted portions of this rating (redacted to remove personal contact information):

I consent to publication of my name and rating in Company marketing materials.

I consent to publication of my rating only if my identity is kept anonymous.

PAYMENT TERMS

If compensation is payable for completion of this rating, the following terms govern payment.

Fee Amount Payment Schedule / Method Late Payment Charge

TERM AND TERMINATION

This Form is effective for the period described below unless earlier terminated in accordance with the notice provisions set forth in this section.

Start Date: End Date:

Termination Notice Period

CONFIDENTIALITY

The Customer/Reviewer and the Company each agree that all non-public, proprietary, or business-sensitive information exchanged in connection with this Form, including detailed ratings tied to an identifiable person, constitutes Confidential Information. Each party shall (a) use Confidential Information solely for the purposes of evaluating or improving services under this Form; (b) protect Confidential Information with at least the same degree of care it uses to protect its own confidential information; and (c) not disclose Confidential Information to third parties except as required by law or with prior written consent.

Acknowledgement of confidentiality obligations:

I acknowledge and agree to the confidentiality terms above.

GOVERNING LAW

This Form and any dispute or claim arising out of or in connection with it shall be governed by and construed in accordance with the laws of:

ENTIRE AGREEMENT

This Form, together with any attachments or recorded ratings referenced herein, constitutes the entire agreement between the parties with respect to the subject matter and supersedes all prior and contemporaneous agreements, proposals, understandings, representations, and warranties, whether written or oral.

CERTIFICATION

By signing below, the Customer/Reviewer certifies that the information and ratings provided are true, accurate, and based on the Customer/Reviewer's personal experience. The Company acknowledges receipt of this rating and agrees to treat the rating and associated Confidential Information in accordance with the terms of this Form.

Customer/Reviewer:

By:

Date:

Company/Provider:

By:

Date:

What the Customer Rating Information Form Is

Customer Rating Information Form is a standardized document used to collect ratings and feedback about a customer’s experience, performance, or account interactions for internal quality control and regulatory recordkeeping. Organizations use it to capture structured evaluations, numeric scores, and brief comments tied to specific transactions or service events. The form typically records reviewer identity, date, rating scale, and categorical descriptors so responses can be audited, trended, and integrated with CRM or compliance systems. When completed accurately it supports operational improvement, dispute resolution, and transparent reporting while preserving an audit trail for legal or regulatory review.

Why a Standardized Rating Form Matters

A Customer Rating Information Form centralizes feedback, creates a verifiable audit trail, and standardizes how organizations measure customer interactions. It helps reduce disputes, supports regulatory compliance where records are required, and provides consistent data for quality improvement and reporting.

Typical Users and How Teams Rely on It

Operations, customer service, compliance teams, and account managers commonly use the Customer Rating Information Form to document evaluations and maintain standardized records across teams.

Quality assurance leads: review trends, escalate issues, and authorize corrective actions when ratings fall below thresholds.
Account managers: reference ratings during renewals, clarify service issues, and document client responses.
Compliance and audit teams: verify record retention, chain of custody, and adherence to policies.

Use role-based access and clear assignment fields to ensure each completed form is attributable and retrievable for audits or disputes.

Who Typically Signs or Approves These Forms

Operations Lead

An Operations Lead completes or reviews Customer Rating Information Forms to track service quality metrics and identify systemic issues. They rely on structured fields and consistent scoring to produce reports and recommend process changes based on aggregated data.

Compliance Officer

A Compliance Officer verifies that form fields meet regulatory requirements, documents retention, and audit trail standards. They confirm e-signature legality under ESIGN and UETA and ensure that records are accessible for legal review and regulatory inquiries.

Essential Elements of a Professional Rating Form

A professional Customer Rating Information Form combines structured numeric fields, clear reviewer attribution, contextual comments, signature and date, version control, and links to related records for reliable auditing and reporting.

Identifiers

Include unique customer account ID, transaction reference, and form version to link ratings to specific events; consistent identifiers enable aggregation across CRM records and simplify audit queries.

Rating Scale

Define a clear numeric or categorical scale (for example 1–5) with written descriptors for each level; document any mapping rules when integrating multiple teams’ scales.

Reviewer Info

Capture reviewer name, role, contact, and authentication method so each entry can be attributed; this supports dispute resolution and regulatory audits requiring signer identification and timestamp.

Comments

Provide a concise free-text field for factual observations and a controlled multiple-choice field for root-cause classification to facilitate clean analytics without exposing unnecessary PII, and optional opinion flag.

Signatures

Include signature fields, signer role, and date; capture electronic signature metadata (IP, timestamp, authentication method) to strengthen attribution and legal enforceability, and retention proof for audit purposes.

Audit Trail

Maintain an immutable audit trail documenting field edits, version history, signer actions, and exportability to meet compliance and support legal or regulatory review with tamper-evident controls and retention logs.

Required Data Elements

Reviewer Name: Enter full legal name as on ID.

Reviewer Role: Specify job title or department.

Rating Scale: Use numeric scale 1–5 or 1–10.

Date: Use MM/DD/YYYY format for consistency.

Comments: Limit to 250 characters; factual observations.

Account ID: Use customer account number or CRM ID.

Risks and Consequences of Errors

Record Inaccuracy: May undermine audits.

Missing Signatures: Can void record.

Retention Failure: Regulatory penalties possible.

Unauthorized Access: Breach notification risk.

Incorrect Attribution: Dispute escalation likely.

Noncompliant E-sign: May not be enforceable.

Common Preparation Mistakes to Avoid

Incomplete fields or ambiguous ratings that lack reviewer context lead to misinterpretation and make trend analysis unreliable across reporting periods.
Using different rating scales or altering scale mid-period without mapping rules causes inconsistent datasets and invalid comparisons between teams or timeframes.
Failing to include an effective date, reviewer identity, or signatory consent can complicate legal verification and obstruct audits.
Collecting sensitive health or financial details on a non-secure form risks HIPAA or financial privacy violations without proper safeguards or BAAs.

How to Complete the Form: Step-by-Step

Follow these core steps to populate, review, and finalize the Customer Rating Information Form in a consistent, auditable manner.

01

1. Identify: Select customer and transaction identifiers to link the rating.
02

2. Rate: Enter numeric score and select categorical options as defined.
03

3. Comment: Add concise factual observations in the comments field.
04

4. Sign: Authenticate and apply your electronic signature and date.

Typical Digital Workflow for Collection and Routing

[INTRO] Typical routing and completion flow for a Customer Rating Information Form in digital workflows and automated systems.

Upload: Sender uploads form and pre-fills known fields.
Assign: Assign reviewers with due dates and permissions.
Sign: Reviewer authenticates and applies e-signature or initials.
Archive: Signed copy stored with audit trail and metadata.

Recommended Workflow Settings

Set these fields and rules when configuring an online Customer Rating Information Form workflow carefully.

Field	Configuration
Signing Order	Sequential approval with manager sign-off required.
Required Fields	Reviewer name, rating, date, and comments mandatory.
Authentication	Email link plus optional SMS code for higher assurance.
Retention	Store signed record for audit with immutable timestamp.

Platform and Integration Requirements

Typical platform and integration requirements for e-submission and distribution include API access, cloud storage connectors, secure authentication, and compatibility with common document formats.

Formats: PDF, DOCX, and HTML supported.
Integrations: Salesforce, NetSuite, Google Workspace supported.
Authentication: Email, SMS, SSO options available.

Timing Considerations and Service Deadlines

Key timing considerations for issuing, collecting, and retaining Customer Rating Information Forms across operations and compliance processes.

Issue Upon Event:

Issue immediately after the customer interaction or transaction.

Reviewer Deadline:

Set a 7–14 day window for submitting evaluations.

Retention Start:

Retention begins on the form's effective date.

Audit Availability:

Ensure records are searchable and exportable within two business days.

Periodic Review:

Quarterly reviews identify scoring drift and process issues.

Key Milestones from Issue to Archive

Key milestones from issuing to archival for the Customer Rating Information Form and expected actions at each stage.

01

Issue Form

Generate and distribute immediately after the customer interaction.

02

Complete Review

Reviewer submits evaluation within the assigned 7–14 day window.

03

Finalize Record

Capture signatures, audit trail, and lock the record for edits.

04

eSignature Pricing and Feature Comparison

Pricing and capability overview for common eSignature vendors, focused on features relevant to Customer Rating Information Forms.

	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 trial	Varies by plan	Varies by plan	Varies by plan	Varies by plan
Bulk Send	Yes	Yes	Yes	Yes	No
Audit Trail	Yes	Yes	Yes	Yes	Yes
HIPAA Compliant	Yes	Yes	Yes	No	No

Frequently Asked Questions

Answers to common questions about completing, signing, and storing the Customer Rating Information Form safely.

Need help? Contact support

Can this form be e-signed?
Yes — electronic signatures are generally enforceable under the ESIGN Act (15 U.S.C. §7001) and UETA where adopted, provided intent, consent, attribution, and retention requirements are met. Exceptions include wills, court orders, and certain notices where electronic signing is prohibited.
What makes an e-signature valid?
Validity requires demonstrating signer intent, consenting to electronic transactions (ESIGN consumer disclosure for consumer-facing records), reliable attribution of the signature to the signer, and retention/reproducibility of the record. Audit trails, timestamps, and authentication strengthen the legal presumption of validity.
Is notarization or witness required?
Not normally for internal rating forms, but state rules vary for documents affecting title or legal status. Remote online notarization is permitted in most states with identity proofing and recording requirements; check state notary commission for specific RON rules.
How long should these records be kept?
Keep active records for the life of the account plus at least three years; financial or tax-linked records follow IRC §6501(a) minimums, and healthcare records with PHI require six years under 45 CFR §164.530(j). State laws may require longer retention.
Can I collect PHI on this form?
You may collect PHI only when necessary and with proper authorization; platforms must support HIPAA-compliant workflows and a signed BAA. Retain PHI records for six years and apply access controls and encryption (45 CFR §164.530(j)).
What are common errors to avoid?
Common errors include inconsistent rating scales, missing reviewer identity or date, lack of signer consent for electronic records, failure to retain audit trails, and storing PHI without HIPAA protections; correct these to preserve enforceability and auditability.

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