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How did we do today?
 
 
 
How did you hear about us?
 
 
 
Did an associate help you?
 
 
 
How often do you shop here?
 
First time
 
1-5 times a month
 
6 or more

 
 
 
How was the overall appearance of the store?
 
Excellent
 
Fair
 
Bad

 
 
 
Did you wait long?
 
Yes
 
No

 
 
 
How likely are you to recommend us to others?
 
Very Likely
 
Kind of Likely
 
Not Likely at all

 
 
 
Comments/Suggestions: Please let us know what we can do to improve our business to keep you as a customer