Zarca Interactive

Sample Customer Satisfaction Survey/ Sample Questions for Customer Satisfaction Survey

Understanding why recent customers do not plan to return to a particular store, this survey addresses reasons for dissatisfaction and requests suggestions on how the store can improve.
Do you ever plan to return to this store?
Yes
No
Overall, please rate the quality of customer service that you received during this visit.
What were the main reasons for the poor quality of customer service? Please select all that apply.
Not attentive enough
Too pushy
Not knowledgeable enough
Rude
Disrespectful
Did not listen to my needs
Too slow
Other (please specify)
Did you file a formal complaint regarding the customer service?
Yes
No
When was this complaint filed?
During the visit to the store
After the visit to the store
Did anyone from the store follow-up with you about the complaint?
Yes
No
Would you like a store representative to contact you?
Yes
No
If you answered "yes" to the previous question and would like a store representative to contact you, please indicate your preferred telephone number here.
Were you satisfied with the follow-up to your complaint?
Yes
No
Why weren't you satisfied with the follow-up to your complaint?
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Overall, please rate the quality of the appearance of the store during this visit.
What were the main reasons for the poor appearance of the store? Please select all that apply.
Messy/Too much clutter
Dirty
Too crowded (e.g. aisles weren't big enough)
Interior decoration was unappealing
Exterior space was unappealing
Other (please specify)
Overall, please rate the quality of the product(s)/service(s) provided by this store.
What were the main reasons for the poor product(s)/service(s)?
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How likely is it that you will go to another store to obtain the product(s)/service(s)?
Please provide any suggestions for improving the quality of the store with respect to customer service, appearance, product/service, etc.
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How many times have you visited this store location in the past?
None
1 to 2 times
3 to 5 times
6 to 10 times
11 or more times
What was the product(s)/service(s) you were shopping for when you visited this store? Please select all that apply.
Product/Service 1
Product/Service 2
Product/Service 3
Product/Service 4
Product/Service 5
Was this the first time you purchased the product(s)/service(s) from any store?
Yes
No
What is your gender?
Female
Male
What is your age?
18 to 25
26 to 34
35 to 49
50 to 64
65 and over
What is the highest level of education that you have achieved?
Less than high school degree
High school degree or GED
Associates degree or trade school
College degree
Graduate school degree
What was your household income last year?
$0 to $24,999
$25,000 to $49,999
$50,000 to $74,999
$75,000 to $99,999
$100,000 to $124,999
$125,000 to $149,999
$150,000 or more