[INSERT COMPANY LOGO]
[INSERT NAME OF SURVEYING COMPANY]
[INSERT ADDRESS OF SURVEYING COMPANY]
[INSERT CONTACT INFORMATION OF SURVEYING COMPANY]
FEEDBACK SURVEY
This survey seeks to acquire your feedback on our products and services, which you recently received from our company. Your answers to this 00.00 minute survey will aid our company in improving our products and services to provide you only the best. Rest assured that your answers will be kept in confidence, and will only be used for the purposes of this survey.
General Customer Background
Please indicate your gender.
◻ Male
◻ Female
◻ Prefers not to answer
Which age group/range do you belong to?
◻ Younger than 18 years old
◻ 18 to 25 years old
◻ 26 to 35 years old
◻ 36 to 45 years old
◻ 46 to 55 years old
◻ 56 to 65 years old
◻ Older than 65 years old
Is it your first time to purchase and avail of any product and service from [INSERT NAME OF COMPANY]? (If yes, proceed to question no. 3.)
◻ Yes
◻ No
How long have you been purchasing from our store?
◻ Less than 6 months
◻ More than 6 months to one year
◻ More than one year
◻ Patron of the company
◻ Registered product user
Which of our customer offers did you purchase and avail of? (If you answer ‘Services’, proceed to no. 5.)
◻ Products
◻ Services
◻ Others, please specify [ ]
What kind of products do you purchase from our store? (You can pick more than one of the selections provided.)
[INSERT PRODUCT DETAILS]
What kind of services do you avail from our store? (You can pick more than one of the selections provided.)
[INSERT SERVICE DETAILS]
Customer Product/Service Feedback
How satisfied are you after using our products or experiencing our services?
◻ Extremely Satisfied
◻ Somewhat Satisfied
◻ Average
◻ Somewhat Dissatisfied
◻ Extremely Dissatisfied
What attributes do our products/services possess which please or satisfy the most? (You can make more than one selection.)
On Products:
◻ High Standard Quality
◻ Convenient for Daily Use
◻ Affordable Price
◻ User-Friendly
◻ Easy to Move
◻ Easily Fits Into Small Spaces
On Services:
◻ Quick and Fast Services
◻ Available Customer Support
◻ Simplified Process
◻ Polite and Professional Service Employees
◻ Always Provide Good Advice and Tips
How likely are you going to recommend our store to your friends, relatives, or colleagues?
◻ Extremely Likely
◻ Somewhat Likely
◻ Neutral
◻ Somewhat Unlikely
◻ Extremely Unlikely
(For Subscribers/Members only)
How likely are you to continue doing business with our store?
◻ Extremely Likely
◻ Somewhat Likely
◻ Neutral
◻ Somewhat Unlikely
◻ Extremely Unlikely
(For Non-Subscribers/Non-Members only)
Are you interested in availing our subscription/membership programs granting rewards and discount privileges?
◻ Extremely Interested
◻ Somewhat Interested
◻ Undecided
◻ No
(For Subscribers/Members only)
How often do you avail of store rewards and privileges for subscribers/members?
◻ Very Often
◻ Sometimes
◻ Average
◻ A Few Times
◻ Rarely
(For Subscribers/Members only)
How satisfied are you with the rewards and privileges for subscribers/members?
◻ Extremely Satisfied
◻ Somewhat Satisfied
◻ Average
◻ Somewhat Dissatisfied
◻ Extremely Dissatisfied
Indicate your comments and suggestions for improvement.
Thank you for answering this survey!
[INSERT TAGLINE/SLOGAN]
[INSERT COMPANY LOGO]
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