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How satisfied are you with the following:
Very Unsatisfied Unsatisfied Neutral Satisfied Very Satisfied
Website
Customer Service
Overall
 
 
 
What is your gender?
 
Male
 
Female
 
 
 
How often do you conduct surveys?
 
Weekly
 
Monthly
 
Quarterly
 
Annually
 
 
 
Comments/Suggestions:
   
 
 
 
What is your gender?
 
Male
 
Female
 
 
 
What is your marital status?
 
Single (Never married)
 
Married
 
Domestic partnership
 
Widowed
 
Divorced
 
Separated
 
Don’t know
 
 
 
What is your age?
 
Younger than 18
 
18 - 24
 
25 - 34
 
35 - 44
 
45 - 54
 
55 - 64
 
65 or older
 
Prefer not to answer
 
 
 
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 would you rate your overall level of satisfaction with us?
 
Highly satisfied
 
Somewhat satisfied
 
Neutral
 
Somewhat dissatisfied
 
Highly dissatisfied
 
Comment:
 
 
 
How likely are you to continue using our products?
 
Very likely
 
Somewhat likely
 
Neutral
 
Somewhat unlikely
 
Very unlikely
 
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