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Have you ever ordered [PRODUCT] from [COMPANY]?
 
Yes
 
No
 
 
 
Overall, how would you rate [COMPANY]?
 
Excellent
 
Good
 
Average
 
Poor
 
Terrible
 
 
 
How satisfied are you with your service from [COMPANY]?
 
Extremely satisfied
 
Very satisfied
 
Neutral
 
Very dissatisfied
 
Extremely dissatisfied
 
 
 
Would you recommend [COMPANY] to a friend?
 
Yes
 
No
 
 
 
What are the THREE main reasons you didn't purchase [PRODUCT] from [COMPANY]?
   
 
 
 
Are there any other comments you have for [COMPANY]?
   
 
 
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)
 
 
 
How often do you use [PRODUCT]?

 
Once a week or more often
 
2 to 3 times a month
 
Once a month
 
Every 2-3 months
 
2-3 times a year
 
Once a year or less often
 
Do not use
 
 
 
Overall, how satisfied are you with [PRODUCT]?
 
Very Unsatisfied
 
Unsatisfied
 
Somewhat Satisfied
 
Very Satisfied
 
Extremely Satisfied
 
 
 
Will you use/purchase [PRODUCT] again?
 
Definitely will
 
Probably will
 
Might or might not
 
Probably will not
 
Definitely will not
 
Never used
 
 
 
If you have additional comments for [COMPANY] about your experience with [PRODUCT] that have not been addressed in the survey, please enter them below.
   
 
 
 
Overall, how would you rate [COMPANY]?
 
Excellent
 
Good
 
Average
 
Poor
 
Terrible
 
 
 
Have you ever ordered [PRODUCT] from [COMPANY]?
 
Yes
 
No
 
 
 
Have you ever ordered [PRODUCT] from [COMPANY]?
 
Yes
 
No
 
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