Retail Customer Brand Loyalty Assessment Form
Help us understand your experience and loyalty to our retail brand. Your feedback will guide us in improving our products and services.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Age Group
*
Please Select
Under 18
18-24
25-34
35-44
45-54
55-64
65 or older
Gender
Female
Male
Non-binary / Third gender
Prefer not to say
Other
How often do you shop with our brand?
*
Weekly
Monthly
Every few months
Once a year or less
This was my first time
Please rate your agreement with the following statements about our brand.
*
Rows
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I trust this brand.
1
2
3
4
5
I feel emotionally connected to this brand.
6
7
8
9
10
This brand offers good value for money.
11
12
13
14
15
This brand meets my needs better than competitors.
16
17
18
19
20
How satisfied are you with the quality of our products/services?
*
1
2
3
4
5
How likely are you to recommend our brand to a friend or colleague?
*
Not likely at all (0)
0
1
2
3
4
5
6
7
8
9
Extremely likely (10)
10
0 is Not likely at all (0), 10 is Extremely likely (10)
Which of the following best describes your participation in our loyalty program?
*
I am an active member and use it regularly.
I am a member but rarely use it.
I am not a member but interested in joining.
I am not interested in the loyalty program.
What do you value most when choosing a retail brand? (Select up to 3)
*
Product quality
Price
Customer service
Brand reputation
Product range/variety
Loyalty program
Sustainability/ethics
Other
Please share any suggestions or feedback to help us improve your experience.
Submit Assessment
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