First Order Customer Survey
Share your feedback about your first order so we can understand your experience and improve future orders. Use the exact same title text across the form.
Customer and First-Order Details
Customer Name
First Name
Last Name
Email Address
*
example@example.com
Order Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Order Number or Reference
Product or Item Purchased
*
Order Channel
*
Please Select
Website
Mobile App
Store
Phone
Marketplace
Other
Was this your first order with the brand?
*
Yes
No
Customer Experience Survey
Overall satisfaction
*
1
2
3
4
5
Ease of ordering
*
Very easy
Easy
Neutral
Difficult
Very difficult
Clarity of product information
*
Very clear
Clear
Neutral
Unclear
Very unclear
Checkout experience
*
Excellent
Good
Fair
Poor
Very poor
Delivery or pickup experience
*
Excellent
Good
Fair
Poor
Very poor
Product quality satisfaction
*
1
2
3
4
5
Likelihood to order again
*
Very unlikely
1
2
3
4
5
6
7
8
9
Very likely
10
1 is Very unlikely, 10 is Very likely
Rate these aspects of your first order
Rows
Very dissatisfied
Dissatisfied
Neutral
Satisfied
Very satisfied
Ordering process
1
2
3
4
5
Product information
6
7
8
9
10
Checkout
11
12
13
14
15
Delivery or pickup
16
17
18
19
20
Product quality
21
22
23
24
25
Feedback and Follow-up
What went well?
What could be improved?
Preferred follow-up contact method
Email
Phone
No follow-up
Submit
Should be Empty: