Product Satisfaction Survey
Date
-
Month
-
Day
Year
Date
Product Name
Where did you hear about this product?
How long have you been using this product?
0-2 years
2-5 years
5-10 years
10+ years
How often do you use this product?
Once a week or more often
3-4 times a month
Once a month
Every 3-4 months
1-2 times a year
Once a year or less
Not using
How satisfied are you with this product?
Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
How likely are you to recommend this product to others?
Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
What are your chances of re-purchasing the product from us?
Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
Have you ever experienced a problem with this product?
Yes
No
If yes, please let us know about the problem
If there was one new idea/recommendation that you could suggest, what would it be and why?
Submit
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