Shopping Basket Assessment Questionnaire
Assess a shopping basket by sharing its goals, contents, priorities, and overall fit for the shopper’s needs.
Basket Profile
Basket Category or Store Type
*
Please Select
Grocery
Convenience Store
Supermarket
Warehouse Club
Online Marketplace
Specialty Store
Other
Primary Shopping Goal
*
Estimated Basket Value or Budget Range
Please Select
Under $25
$25-$50
$51-$100
$101-$250
Over $250
Other
Number of Items in the Basket
*
Assessment Details
Basket Item Attributes
*
Assessment Factors
*
Rows
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Price Sensitivity
1
2
3
4
5
Quality Preference
6
7
8
9
10
Convenience
11
12
13
14
15
Variety
16
17
18
19
20
Overall Basket Satisfaction
*
1
2
3
4
5
Preferences and Notes
Preferred brands or product types
Shopping constraints or dealbreakers
Budget under $50
Only eco-friendly products
Avoid certain ingredients
Need specific size or fit
Prefer premium brands
Store pickup only
Online only
Other
Additional comments
Submit
Should be Empty: