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Hello:

You are invited to participate in our survey [Project Description Here]. In this survey, approximately [Approximate Respondents] people will be asked to complete a survey that asks questions about [General Survey Process]. It will take approximately [Approximate Time] minutes to complete the questionnaire.


Your participation in this study is completely voluntary. There are no foreseeable risks associated with this project. However, if you feel uncomfortable answering any questions, you can withdraw from the survey at any point. It is very important for us to learn your opinions.


Your survey responses will be stricly confidential and data from this research will be reported only in the aggregate. Your information will be coded and will remain confidential. If you have questions at any time about the survey or the procedures, you may contact [Name of Survey Researcher] at [Phone Number] or by email at the email address specified below.


Thank you very much for your time and support. Please start with the survey now by clicking on the Continue button below.


 
 
 
Favorite Drink...
 
Coke
 
Pepsi
 
Sprite
 
Mountain Dew
 
A&W Root Beer
 
 
 
Additional Comments/Suggestions for improvement
   
 
 
 
Have you ever ordered [PRODUCT] from [COMPANY]?
 
Yes
 
No
 
 
 
Overall, how would you rate [COMPANY]?
 
Excellent
 
Good
 
Average
 
Poor
 
Terrible
 
 
 
How satisfied are you with your service from [COMPANY]?
 
Extremely satisfied
 
Very satisfied
 
Neutral
 
Very dissatisfied
 
Extremely dissatisfied
 
 
 
Would you recommend [COMPANY] to a friend?
 
Yes
 
No
 
 
 
If no, why not?
   
 
 
 
For your NEXT [PRODUCT] purchase, how likely are you to purchase from [COMPANY]?
 
Very likely
 
Somewhat likely
 
Not sure
 
Somewhat unlikely
 
Very unlikely
 
 
 
Which of the following modes did you use to place the LAST order for [PRODUCT]?
 
Mail order
 
Internet
 
Over the phone
 
Fax
 
Other
 
 
 
 
What are the THREE main reasons you didn't purchase [PRODUCT] from [COMPANY]?
   
 
 
 
If you could change something about [COMPANY] what would it be?
   
 
 
 
Are there any other comments you have for [COMPANY]?
   
 
Please contact [email protected] if you have any questions regarding this survey.
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