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Age
 
 
 
Sex
 
Male
 
Female
 
 
 
Marital Status
 
Married
 
Single
 
Other
 
 
 
What was the last grade you completed in school?
 
Some high school
 
High school graduate
 
Some college
 
College graduate
 
Postgraduate/professional
 
 
 
How often do you use [PRODUCT]?
 
daily
 
once/week or more
 
2 to 3 times a month
 
once/month
 
every 2-3 months
 
2-3 times a year
 
 
 
How likely are you to use/purchase [PRODUCT] again?
 
Definitely
 
Probably
 
Might or might not
 
Probably not
 
Definitely not
 
Never used
 
 
 
How long have you used [PRODUCT]?
 
Less than 1 month
 
1 to 6 months
 
6 months to 1 year
 
1 to 3 years
 
Not sure
 
Never used
 
Other
 
 
 
 
Would you recommend [PRODUCT] to others?
 
Definitely
 
Probably
 
Might or might not
 
Probably not
 
Definitely not
 
N/A
 
 
 
Overall, how satisfied are you , with [PRODUCT/SERVICE]?
 
Very satisfied
 
Satisfied
 
Neutral
 
Dissatisfied
 
Very dissatisfied
 
Not sure
 
 
 
How likely are you to use/purchase [PRODUCT] again?
 
Definitely
 
Probably
 
Not sure
 
Probably not
 
Definitely not
 
Never used
 
 
 
Would you recommend [PRODUCT OR SERVICE] to others?
 
Definitely
 
Probably
 
Not sure
 
Probably not
 
Definitely not
 
Never used
 
 
How satisfied are you with regarding the following items?
PRODUCT
Very Unsatisfied Unsatisfied Neutral Satisfied Very Satisfied Not Applicable
Overall quality
Value
Purchase experience
Installation or first use experience
Usage experience
After purchase service (warranty, repair, customer service etc)
 
 
 
Compared to other [PRODUCT CATEGORY] that are available, would you say that [PRODUCT] is...
 
Much better
 
Somewhat better
 
About the same
 
Somewhat worse
 
Much worse
 
Don't know or never used
 
 
 
Will you use/purchase [PRODUCT] again?
 
Definitely will
 
Probably will
 
Might or might not
 
Probably will not
 
Definitely will not
 
Never used
 
 
 
Based on your experience with [PRODUCT], how likely are you to buy a [OTHER PRODUCT] again?


 
Very Unlikely
 
Unlikely
 
Somewhat Unlikely
 
Very Likely
 
Extremely Likely
 
 
 
If you contacted [COMPANY] customer service, were all problems resolved to your complete satisfaction?
 
Yes, by the company or its representatives
 
Yes, by me or someone outside the company
 
No, the problem was not resolved
 
No problems/No contact with customer service
 
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