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Select the rating that best describe how you feel about this service.
Low
1

2

3

4
High
5
Quality
Price
Trustworthy Brand
Craftsmanship/Design
Value for Price Paid
 
 
 
Please read the following description of a new service concept in order to complete the survey.

[ENTER A DESCRIPTION OF THE SERVICE HERE]
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After reading the above service description, how interested would you be in using the described service?
 
Not at all interested
 
Not very interested
 
Neither interested nor uninterested
 
Somewhat interested
 
Extremely interested
 
 
 
What features/attributes of this service are the most valuable to you?
   
 
 
 
What do you find least appealing about this service?
   
 
 
 
Overall, how interested are you in buying this service?
 
Not at all interested
 
Not very interested
 
Neither interested nor uninterested
 
Somewhat interested
 
Extremely interested
 
 
 
Based on the description, what price would you expect to pay for the service? Please record one number, not a range.
   
 
 
 
If [list of additional features] were added to the basic concept, what is the amount you would expect to pay?
   
 
 
 
If you wanted to buy/have this new service, which purchase method would you most prefer?
 
Calling and ordering by telephone
 
Ordering through the mail
 
Going to the company/place of business/office
 
Using the Internet
 
Other
 
 
 
[Concept] might be used at different times or occasions. Please rank the following occasions by placing a 1 next to the occasion of greatest expected use, a 2 next to the occasions of next greatest expected use and so forth until all items are ranked.
Occasion 1
Occasion 2
Occasion 3
Occasion 4
 
 
 
Which groups of people do you expect to be the greatest users of this service? Please check three (3).
 
Self
 
Family member
 
Co-worker
 
Business/Organization partner
 
Student
 
Other adult
 
Teen 13-18 years
 
Child 8-12 years
 
Child 2-7 years
 
Infant under 2

 
 
 
How often do you use products from this [Service Category]?
 
Every day
 
More than once a week
 
Once a week
 
About every two weeks
 
Once a month
 
Every three months
 
Two-three times a year
 
Once a year
 
Less often
 
Never used
 
 
 
How aware are you of the following companies that offer similar services? Please check all that apply.
 
Brand A
 
Brand B
 
Brand C

 
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