Survey Form
Let us know how we can improve
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Name:
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Email:
Contact Number:
Age:
Gender:
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Female
Male
I rather not say
Overall, how satisfied or dissatisfied are you with our company?
Very satisfied
Somewhat satisfied
Neither satisfied nor dissatisfied
Somewhat dissatisfied
Very dissatisfied
Which of the following words would you use to describe our products? Select all that apply.
Reliable
High quality
Useful
Unique
Good value for money
Overpriced
Impractical
Ineffective
Poor quality
Unreliable
How well do our products meet your needs?
Extremely well
Very well
Somewhat well
Not so well
Not at all well
How would you rate the value for the money of the product?
Excellent
Above average
Average
Below average
Poor
How responsive have we been to your questions or concerns about our products?
Extremely responsive
Very responsive
Somewhat responsive
Not so responsive
Not at all responsive
Not applicable
How long have you been a customer of our company?
This is my first purchase
Less than six months
Six months to one year
1 - 2 years
3 or more years
I haven't made a purchase yet
How likely are you to purchase our products again?
Extremely likely
Very likely
Somewhat likely
Not so likely
Not at all likely
Do you have any other comments, questions, or concerns?
Done