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How long have you used our products?
 
Less than 6 months
 
6 months to less than 1 year
 
1 year to less than 3 years
 
3 years to less than 5 years
 
5 years or more
 
 
 
How frequently do you purchase from us?
 
Every day
 
Every week
 
Every 2 - 3 weeks
 
Every month
 
Every 2 - 3 months
 
Every 4 - 6 months
 
Once or twice a year
 
 
 
How would you rate your level of satisfaction with us?
 
Highly satisfied
 
Somewhat satisfied
 
Neutral
 
Somewhat dissatisfied
 
Highly dissatisfied
 
 
 
Where do you purchase our products? Select all that apply.
 
In our store
 
Online
 
Telephone order/catalogue
 
Through a dealer
 
Through an agent
 
Through a wholesaler
 
Other
 
 
 
How likely are you to continue using our products?
 
Very likely
 
Somewhat likely
 
Neutral
 
Somewhat unlikely
 
Very unlikely
 
 
 
How helpful is our company with your needs or questions?
 
Extremely helpful
 
Very helpful
 
Moderately helpful
 
Slightly helpful
 
Not at all helpful
 
 
 
How does our product quality compare to similar products on the market?
 
Much better
 
Slightly better
 
About the same
 
Slightly worse
 
Much worse
 
 
 
In general, how satisfied are you with the employees you interacted with?
 
Extremely satisfied
 
Slightly satisfied
 
Neither satisfied nor dissatisfied
 
Slightly dissatisfied
 
Extremely dissatisfied
 
 
 
In general, how satisfied are you with our new product?
 
Extremely satisfied
 
Slightly satisfied
 
Neither satisfied nor dissatisfied
 
Slightly dissatisfied
 
Extremely dissatisfied
 
 
 
What is your gender?
 
Male
 
Female
 
 
 
Which of the following categories best describes the industry you work in?
 
Automotive
 
Advertising
 
Consulting Services
 
Education
 
Entertainment
 
Financial Services
 
Government Services
 
Healthcare
 
Human Resources
 
Information Technology
 
Marketing/Sales
 
Non-Profit
 
Pharmaceuticals
 
Public Relations
 
Technical Services
 
Travel
 
Other
 
 
 
How many children do you have?
 
No Children
 
1 child
 
2 children
 
3 children
 
More than 3 children
 
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