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Surveys
2015
April
A
All Question Survey
All Question Survey
0%
Exit Survey
Multiple Choice (Select One)
Completely Unsatisfied
Somewhat Unsatisfied
Slightly Unsatisfied
Neither Satisfied Nor Unsatisfied
Slightly Satisfied
Somewhat Satisfied
Completely Satisfied
Other
Multiple Choice (Select Many)
Visa
Mastercard
American Express
Discover
Diners Club
Other
Drop Down Menu
-- Select --
Weekly
Monthly
Quarterly
Annually
Other
Comments/Suggestions:
Contact Informaton
First Name
:
Last Name
:
Address 1
:
Address 2
:
City
:
State
:
Zip
:
Phone
:
Email Address
:
Matrix Table (Select One)
Very Unsatisfied
Unsatisfied
Neutral
Satisfied
Very Satisfied
N/A
Matrix Table (Select One) - Website
Matrix Table (Select One) - Customer Service
Matrix Table (Select One) - Overall
Matrix Table (Select Many)
Very Unsatisfied
Unsatisfied
Neutral
Satisfied
Very Satisfied
N/A
Matrix Table (Select Many) - Website
Matrix Table (Select Many) - Customer Service
Matrix Table (Select Many) - Overall
Spreadsheet
Yes
No
N/A
Spreadsheet - Website
Spreadsheet - Customer Service
Spreadsheet - Overall
Drag & Drop Image Ranker
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Manchester United
Liverpool
Manchester City
Arsenal
Chelsea
Tottenham HotSpur
Rank Order
Skiing
-- Select --
1
2
3
4
5
Snowboarding
-- Select --
1
2
3
4
5
Cricket
-- Select --
1
2
3
4
5
Hockey
-- Select --
1
2
3
4
5
Biking
-- Select --
1
2
3
4
5
Constant Sum
Essentials (Gas, Grocery etc.)
Entertainment (Movies, Clubs etc.)
Other
0
Star Rating
Star Rating - Books
Star Rating - Movies
Star Rating - Music
Smiley Faces
Very Unsatisfied
Unsatisfied
Neutral
Satisfied
Very Satisfied
Thumbs Up/Down
Love it
Hate it
Image Chooser (Select One)
Manchester United
Chelsea
Arsenal
Liverpool
Manchester City
Image Chooser (Select Many)
Manchester United
Chelsea
Liverpool
Arsenal
Manchester City
Image Rating
Manchester United
-- Select --
1
2
3
4
5
Chelsea
-- Select --
1
2
3
4
5
Liverpool
-- Select --
1
2
3
4
5
Arsenal
-- Select --
1
2
3
4
5
-- Select --
1
2
3
4
5
TubePulse Rating
What is your date of birth?
Month
Day
Year
Hrs.
Mins.
AM/PM
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AM
PM
Importance
Satisfaction
Not Important
Very Important
Not Satisfied
Very Satisfied
1
2
3
4
5
1
2
3
4
5
Customer Service
Product Packaging
On-Time Arrival
Net Promoter Score
«Very Unlikely
Very Likely»
0
1
2
3
4
5
6
7
8
9
10
Scale Graphical Numeric Slider
Scale Graphical Numeric Slider - Website
-
Scale Graphical Numeric Slider - Customer Service
-
Scale Graphical Numeric Slider - Overall
-
Scale Graphical Text Slider
Very Unsatisfied
Unsatisfied
Neutral
Satisfied
Very Satisfied
Scale Graphical Text Slider - Website
-
Scale Graphical Text Slider - Customer Service
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Scale Graphical Text Slider - Overall
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