Internet Purchase Dialog Survey Template

Internet purchase dialog survey to determine shopper feedback to the internet retailer while shopping?



   

Thinking back to the Internet retailers you've purchased from, have you ever:
Yes No
Provided feedback on the products or services they sell?
Completed a survey for that Internet retailer?
Communicated with other users via e-mail or chat rooms?
 
   
 
Please check the product or service category you most recently purchased on-line.
 
Books
 
Financial services
 
Computer equipment
 
CDs
 
Clothes
 
Other
    

 
   
 
Which Internet retailer did you use (please specify the URL):
   
 
   
 
When you began shopping on this occasion, were you:
 
Surfing the net with no intent to purchase
 
Surfing the net with intent to make a purchase.
 
Other
    
 
   
 
How much did you spend on this last transaction?
 
Less than $25
 
$26-$50
 
$51-$75
 
$76-$100
 
Between $100-200
 
Other
    
 
   
 
Did you return the merchandise or cancel the service after you received it?
 
Yes
 
No
 
   
 
Did you contact the customer service department of this Internet retailer with a complaint or problem?
 
Yes
 
No
 
   
 
How much would you estimate you have spent with this Internet retailer in the past twelve months?
 
Less than $50
 
$51-$100
 
$101-$150
 
$151-$200
 
Between $200-500
 
Other
    
 
   
 
How many transactions have you made with this Internet retailer over the past 12 months?
 
1
 
2
 
3
 
4
 
5
 
Don't remember
 
Other (please specify)
    
 
   
 
Thank you for your participation.
 

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