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2005
March
T
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Hello:
You are invited to participate in our survey [Project Description Here]. In this survey, approximately [Approximate Respondents] people will be asked to complete a survey that asks questions about [General Survey Process]. It will take approximately [Approximate Time] minutes to complete the questionnaire.
Your participation in this study is completely voluntary. There are no foreseeable risks associated with this project. However, if you feel uncomfortable answering any questions, you can withdraw from the survey at any point. It is very important for us to learn your opinions.
Your survey responses will be stricly confidential and data from this research will be reported only in the aggregate. Your information will be coded and will remain confidential. If you have questions at any time about the survey or the procedures, you may contact [Name of Survey Researcher] at [Phone Number] or by email at the email address specified below.
Thank you very much for your time and support. Please start with the survey now by clicking on the
Continue
button below.
Choose your drink...
Coke
Pepsi
Sprite
Mountain Dew
A&W Root Beer
Additional Comments/Suggestions for improvement
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
Overall, how satisfied are you with [PRODUCT]?
Very Unsatisfied
Unsatisfied
Somewhat Satisfied
Very Satisfied
Extremely Satisfied
Overall, how would you rate [COMPANY]?
Excellent
Good
Average
Poor
Terrible
For your
NEXT
[PRODUCT] purchase, how likely are you to purchase from [COMPANY]?
Very likely
Somewhat likely
Not sure
Somewhat unlikely
Very unlikely
What are the
THREE
main reasons you didn't purchase [PRODUCT] from [COMPANY]?
If you could change something about [COMPANY] what would it be?
Please contact
[email protected]
if you have any questions regarding this survey.
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