Vehicle Survey Form
Please complete this survey to help us understand your vehicle and your experience as an owner or user.
What is the make of your vehicle?
*
What is the model of your vehicle?
*
What year was your vehicle manufactured?
*
What type of vehicle do you own or use?
*
Sedan
SUV
Truck
Van
Coupe
Convertible
Hatchback
Other
How long have you owned or used this vehicle?
*
Less than 1 year
1-3 years
4-7 years
More than 7 years
How frequently do you use your vehicle?
*
Daily
Several times a week
Weekly
A few times a month
Rarely
How satisfied are you with your vehicle’s overall performance?
*
1
2
3
4
5
Please rate the following aspects of your vehicle.
*
Rows
Very Dissatisfied
Dissatisfied
Neutral
Satisfied
Very Satisfied
Fuel efficiency
1
2
3
4
5
Comfort
6
7
8
9
10
Safety features
11
12
13
14
15
Technology/features
16
17
18
19
20
What is the primary purpose for which you use your vehicle?
*
Commuting to work/school
Leisure/recreation
Business/commercial use
Family/household errands
Other
Please share any additional comments or suggestions about your vehicle.
Submit Survey
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