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Blank survey template

[INSERT SURVEY TITLE]



Prepared By: [SPECIFY THE NAME]


Name (Optional):


Age:


Gender:


Address:


Contact Number:




Date of Survey: 00.00.20 [ ]


1. I discovered [SPECIFY THE NAME OF THE PRODUCT] through [  ].


2. I use the product at least [ ] times in a month.


3. I am [ ] with the product. (State if satisfactory or not)


4. The product is [ ] in my daily activities. (State if helpful or not)


5. My purpose of using the product is [ ].


6. The product is [ ]. (State if effective or not)


7. I am likely to [ ] this product. (State if you will buy the product or not)


8. If given the chance, I would like to change the [ ]. (State the kind of change you want with the product)



Thank you for answering this survey!


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