Supermarket Feedback Form
Share your feedback to help us improve your supermarket experience.
Date of your visit
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Overall, how satisfied were you with your experience?
*
Very dissatisfied
1
2
3
4
Very satisfied
5
1 is Very dissatisfied, 5 is Very satisfied
How would you rate the availability of products you were looking for?
*
Very poor
1
2
3
4
Excellent
5
1 is Very poor, 5 is Excellent
How would you rate the cleanliness of the store?
*
Very poor
1
2
3
4
Excellent
5
1 is Very poor, 5 is Excellent
How would you rate the helpfulness of our staff?
*
Very unhelpful
1
2
3
4
Very helpful
5
1 is Very unhelpful, 5 is Very helpful
How would you rate your checkout experience?
*
Very poor
1
2
3
4
Excellent
5
1 is Very poor, 5 is Excellent
How would you rate the pricing of products?
*
Too expensive
1
2
3
4
Great value
5
1 is Too expensive, 5 is Great value
Which section(s) of the store did you visit?
Produce
Bakery
Deli
Meat & Seafood
Dairy
Frozen Foods
Household
Other
Please share any additional comments or suggestions.
First name (optional)
Submit Feedback
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