Retail Customer Service Quality Questionnaire
Please help us improve our service by sharing your feedback about your recent visit.
Date of your visit
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Which store location did you visit?
*
Please Select
Downtown
Mall Branch
Suburban Store
Other
How did you hear about our store?
Walked by
Online Search
Social Media
Recommendation
Other
Please rate the following aspects of your shopping experience:
*
Rows
Very Poor
Poor
Average
Good
Excellent
Staff helpfulness
1
2
3
4
5
Product availability
6
7
8
9
10
Store cleanliness
11
12
13
14
15
Ease of finding products
16
17
18
19
20
Checkout process
21
22
23
24
25
How satisfied are you with your overall experience?
*
1
2
3
4
5
Were you greeted by a staff member upon entering?
*
Yes
No
Did you find everything you were looking for?
*
Yes
No
Would you recommend our store to others?
*
Definitely
Probably
Not Sure
Probably Not
Definitely Not
What did you like most about your experience?
What can we improve?
Please provide your email address if you would like to be contacted (optional)
example@example.com
Submit Feedback
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