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  5. QuestionPro : Company Satisfaction
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How long have you used our services?
 
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
 
 
 
Which of our [PRODUCTS/SERVICES] do you use? Select all that apply.
 
{OPTION 1}
 
{OPTION 2}
 
{OPTION 3}
 
{OPTION 4}
 
{OPTION 5}

 
 
 
How frequently do you have contact 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
 
 
How much do you rate us on the following attributes?
Well Below Average Below Average Average Above Average Well Above Average
Customer service
Professionalism
Quality of services
Understanding customers' needs
Staff
Price
 
 
Comment:
   
 
 
 
How likely are you to continue doing business with us?
 
Very likely
 
Somewhat likely
 
Neutral
 
Somewhat unlikely
 
Very unlikely
 
 
 
How likely is it that you would recommend our services to a friend or colleague?
 
Very likely
 
Somewhat likely
 
Neutral
 
Somewhat unlikely
 
Very unlikely
 
 
 
Do you have any suggestions for improving our services?
   
 
 
 
What is your gender?
 
Male
 
Female
 
Prefer not to answer
 
 
 
How long have you been at your current business setting?
 
Less than 6 months
 
6 - 12 months
 
13 - 24 months
 
25 - 36 months
 
37 - 48 months
 
greater than 49 months
 
Prefer not to answer
 
 
 
What best describes your employment status?
 
Sole Owner
 
Partner
 
Administrator
 
Employee
 
Manager
 
Prefer not to answer
 
Other
 
 
 
 
Which of the following categories best describes the industry you work in?
 
Allied Healthcare Provider
 
Rehabilitation (outpatient)
 
Outpatient Physical Therapy (single office)
 
Outpatient Physical Therapy (multi-site)
 
Hospital
 
Medical
 
Chiropractic
 
Naturopath
 
Healthcare B2B
 
Healthcare
 
Other
 
 
 
 
Which category best describes your annual income?
 
Under $15,000
 
$15,000 - $29,999
 
$30,000 - $44,999
 
$45,000 - $59,999
 
$60,000 - $74,999
 
$75,000 - $89,999
 
$90,000 or more
 
Prefer not to answer