Retail Customer Service Effectiveness Assessment
Please help us improve by evaluating your recent experience with our retail staff and service.
Your Name (optional)
First Name
Last Name
Email Address (optional, for follow-up if needed)
example@example.com
Date of Visit
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Store Location Visited
*
Please Select
Downtown
Mall Branch
Suburban Outlet
Other
Please rate the following aspects of your experience:
*
Rows
Excellent
Good
Fair
Poor
Friendliness and courtesy of staff
1
2
3
4
Staff product knowledge
5
6
7
8
Speed of service
9
10
11
12
Problem resolution
13
14
15
16
Cleanliness and organization of the store
17
18
19
20
How satisfied were you overall with your experience?
*
1
2
3
4
5
Did you find what you were looking for?
*
Yes
No
How likely are you to recommend our store to others?
*
Not at all likely
1
2
3
4
5
6
7
8
9
Extremely likely
10
1 is Not at all likely, 10 is Extremely likely
What did we do well? (optional)
What could we improve? (optional)
May we contact you for follow-up regarding your feedback?
Yes
No
Submit Assessment
Should be Empty: