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Questionnaire template

Recent Service Visit Feedback

Captures customers' ratings, problems, recommendation intent and stage timings for their most recent service visit.

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Questions in this template

Your Latest Visit

  1. Thank you for your time. Please think about your last contact with us when answering.

  2. How did you last use our service?

    Choose one:

    • In person
    • Online
    • By phone
    • By email or chat

  3. How satisfied were you with each of these?

    • Quality of service
    • Friendliness of staff
    • Speed and efficiency
    • The visit as a whole

    For each row: choose one:

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

  4. Did anything go wrong or cause difficulty during that visit?

    Choose one:

    • Yes
    • No

  5. What happened?

    Condition: Shown when a problem was reported

    Open answer

Your View of Our Service

  1. Does each statement match your experience?

    • Staff knew what they were talking about.
    • I felt welcome.
    • The service was what I expected.

    For each row: choose one:

    • Yes
    • Not sure
    • No

  2. How likely are you to recommend us to others?

    Choose one:

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

  3. What is the main reason for your answer? (optional)

    Open answer

  4. Roughly how many minutes did each stage take?

    • Waiting to be served
    • Being served
    • Paying or checking out

    For each row: a number from 0 to 600

About You

  1. What is your gender?

    Choose one:

    • Female
    • Male
    • Non-binary
    • Prefer not to say

  2. Which age group are you in?

    Choose one from a list:

    • Under 18
    • 18-24
    • 25-34
    • 35-44
    • 45-54
    • 55-64
    • 65 and over

  3. Anything else you would like us to know?

    Open answer