Customer Feedback Form

Overall, how satisfied were you with your most recent experience with us?

Choose one:

• Very dissatisfied
• Dissatisfied
• Neutral
• Satisfied
• Very satisfied

What influenced your answer the most?

Choose one:

• Quality of service
• Speed of service
• Staff knowledge
• Price
• Other

Please tell us a little more about that.

Condition: Shown when a main influence was chosen

Open answer

How likely are you to suggest us to someone you know?

Choose one:

• Very likely
• Likely
• Neutral
• Unlikely
• Very unlikely

Thinking about that experience, how would you rate us on each of the following?

• Professionalism
• Speed of response
• Value for money
• Overall experience

For each row: choose one:

• Very poor
• Poor
• Average
• Good
• Excellent

Which of our offerings do you use most?

Choose one:

• Our core product
• An add-on or accessory
• A subscription or plan
• A support or consulting service
• Other

Is there anything you would like to tell us about it? (optional)

Condition: Shown when an offering was chosen

Open answer

How often do you use our products or services?

Choose one from a list:

• Daily
• Weekly
• Monthly
• Occasionally
• Rarely

What else would you like us to offer?

Open answer

When choosing a provider like us, how much does each factor matter to you? (1 = Not at all important, 10 = Extremely important)

• Price
• Quality
• Customer support
• Reputation

For each row: choose one:

• 1
• 2
• 3
• 4
• 5
• 6
• 7
• 8
• 9
• 10

How could we serve you better?

Open answer

Have you had any problems when using our services?

Choose one:

• Yes
• No

What problems did you have, and what would you suggest we change?

Condition: Shown when problems were reported

Open answer