SIMMONS - Customer Feedback Form

Dear Customer,

Thank you for shopping at Simmons Gallery.

Your feedback is valuable to us. We appreciate if you could fill up this form as we look forward to enhance your shopping experience with us.

All information on this form is kept confidential.

Thank you.

(Please select your response below)

* 1) Which Simmons Gallery did you make your purchase from?

* 2) Please select the mattress(s) model you have purchased.

(Select all that apply)

* 3) What are the top 3 factors that influenced your choice for purchase at this specific store?

(Select 3 options below)

Location

Product Range

Retail Consultant Service

Shopping Mall Tenants & Activities

Simmons In-store promotions

Store Environment

* 4) Please rank the below factors that influence your mattress purchasing decision.

(From 1 being the most important to 6 being the least important)

Aesthetic Design
Brand
Comfort
Price
Retail Consultant Price
Unique Features (eg: AirCool Memory Foam)

* 5) What is the MAXIMUM price range that you are willing to spend on a mattress?

* 6) Which channels do you usually use to search for bedding promotions, news or events?

(Select all that apply)

Direct Mailers

Magazine Advertisement

Newspaper Advertisement

Television Advertisement

Online Advertisement (eg: Banners)

Social Media (eg: Facebook)

Shopping Mall Marketing Collaterals (eg: Flyers)

Word of Mouth

7) Do you have any suggestion or feedback you will like to share with us?

8) What is your MONTHLY household disposable income?

9) Which age group do you belong to?