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Questions marked with an * are required Exit Survey
 
 
* What is your gender?
 
Male
 
Female
 
 
 
What is your age?
 
Younger than 18
 
18 - 24
 
25 - 34
 
35 - 44
 
45 - 54
 
55 - 64
 
65 or older
 
Prefer not to answer
 
 
 
What is your marital status?
 
Single (Never married)
 
Married
 
Domestic partnership
 
Widowed
 
Divorced
 
Separated
 
Don’t know
 
 
 
* How frequently do you purchase from us?
 
Every day
 
Every week
 
Every 2 - 3 weeks
 
Every month
 
Every 2 - 3 months
 
Every 4 - 6 months
 
Once or twice a year
 
 
 
* How would you rate your level of satisfaction with us?
 
Highly satisfied
 
Somewhat satisfied
 
Neutral
 
Somewhat dissatisfied
 
Highly dissatisfied
 
 
 
* Where do you purchase our products? Select all that apply.
 
In our store
 
Online
 
Telephone order/catalogue
 
Through a dealer
 
Through an agent
 
Through a wholesaler
 
Other
 
 
 
* How would you rate your overall level of satisfaction with us?
 
Highly satisfied
 
Somewhat satisfied
 
Neutral
 
Somewhat dissatisfied
 
Highly dissatisfied
 
Comment:
 
 
 
* How do we rate in comparison to other companies that offer the same products?
 
Much higher
 
Somewhat higher
 
Same
 
Somewhat lower
 
Much lower
 
Don't know
 
 
 
* How long have you used our products?
 
Less than 6 months
 
6 months to less than 1 year
 
1 year to less than 3 years
 
3 years to less than 5 years
 
5 years or more
 
 
 
* How well did our staff respond to your needs?
 
Below standard
 
Insufficient
 
Satisfactory
 
Good
 
Excellent
 
 
 
If you return to this location, would you choose to stay with us again?
 
Yes
 
No
 
 
 
* How would you rate our concierge service?
 
Below standard
 
Insufficient
 
Satisfactory
 
Good
 
Excellent
 
 
 
* How frequently do you use our products?
 
Extremely frequently
 
Very frequently
 
Moderately frequently
 
Very infrequently
 
Not at all frequently
 
 
 
* How does our product quality compare to similar products on the market?
 
Much better
 
Slightly better
 
About the same
 
Slightly worse
 
Much worse