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Is the participant in the study male or female
 
Male
 
Female
 
 
 
Was the shopper alone or with someone else?
 
Alone
 
With another individual
 
With a child
 
With a spouse
 
 
 
How old approximately was the person or persons in the study?
 
5-10 years old
 
10-20 years old
 
20-30 years old
 
30-40 years old
 
older than 40
 
 
 
How long was the customer approximately in the store for?
 
10-20 minutes
 
20-30 minutes
 
30-45 minutes
 
over 45 minutes
 
 
 
How easily was the customer able to make his/her way around the store, and how quickly was he/she able to find what they were looking for?
 
The customer had trouble finding what they were looking for
 
The customer was able to find what he/she needed but took a long time in finding it.
 
The customer found what they were looking for in a quick manner.
 
The customer had trouble find what they were looking for and eventually left.
 
 
 
Did the customer seek help from an employee?
 
Yes
 
No
 
 
 
Rate the employee in how well they were able to assist the customers needs.
 
Poor
 
Below Average
 
Average
 
Good
 
Excellent
 
 
 
Did the customer come to the store to buy a few items or did they look around for things that might catch there eye?
 
They bought a few items
 
They bought many items
 
They looked around the store for items they did not necessarily go there for.
 
They looked around the store but left with nothing.
 
 
 
How did the customer seem to appear when they left the store?
 
Very Dissatisfied
 
Not Satisfied
 
Neutral
 
Satisfied
 
Very Satisfied
 
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