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Surveys
2016
February
P
Product Questionnaire TEMPLATE
Product Questionnaire TEMPLATE
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Contact Information
First Name
:
Last Name
:
Phone
:
Email Address
:
How interested would you be in purchasing {PRODUCT NAME & DESCRIPTION}?
Very interested
Interested
Neutral
Uninterested
Very uninterested
Would the following attributes make you more or less interested in purchasing {PRODUCT NAME}?
Much Less Interested
Somewhat Less Interested
Neutral
Somewhat More Interested
Much More Interested
{ATTRIBUTE 1}
{ATTRIBUTE 2}
{ATTRIBUTE 3}
{ATTRIBUTE 4}
{ATTRIBUTE 5}
If this product were available today, when would you be most likely to buy it?
Within the next month
Between 1 and 3 months from now
Between 4 and 6 months from now
Between 7 months and a year from now
I am not interested
Please indicate the degree to which you agree/disagree with the following statements about the similar product you currently use.
Strongly Disagree
Somewhat Disagree
Neutral
Somewhat Agree
Strongly Agree
Sufficient for my needs
Meets my expectations
Reasonably priced
What do you currently use as an alternative to our proposed product?
{ALTERNATIVE 1}
{ALTERNATIVE 2}
{ALTERNATIVE 3}
{ALTERNATIVE 4}
{ALTERNATIVE 5}
I do not use a similar product
Other
Please provide additional comments about your current product.
Which payment method do you prefer?
Cash
Check
Credit card
Debit card
Payment plan
Please provide any additional comments about our proposed product.
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