This sample survey is intended to be used as a template for a customer satisfaction questionnaire for the buying experience of a product.
Product 1 Product 2 Product 3 Product 4
Did you yourself purchase the product?
Yes [Click here if you selected this choice] No -- Someone else purchased
Was the product a gift or did someone else buy it at your request?
Gift Bought per request Other
Thank you for completing this questionnaire. You do not need to answer the remaining questions, which pertain to the actual buying experience itself.
Retail Store Wholesale Store Superstore Catalog Direct From Manufacturer by Telephone Direct From Manufacturer by Web Site Other
Why did you purchase this product here as opposed to somewhere else?
How was your overall purchasing experience?
Excellent Good Fair Poor Unsure
Would you purchase another product through the same means?
Yes No Maybe
Why not, or why aren't you sure?
1 - Poor 2 3 4 5 - Excellent Knowledge of the product Courteousness Willingness to help Efficiency/quickness Ability to complete transaction
NA 1 - Poor 2 3 4 5 - Excellent Convenience Location Efficiency/quickness Product availability Billing accuracy Accuracy of shipment estimate Shipping options
Did you have any coupons or receive any kind of discount?
Yes No Not sure/don't remember
How did the product's pricing compare to your expectations?
Met pricing expectations More expensive than expected Less expensive than expected
How did the product pricing compare to other similar products that you know of?
Most expensive More expensive than many Neither expensive nor inexpensive Less expensive than many Least expensive
On a scale of 1 to 5, where 1 represents very low value and 5 represents very high value, how would you rate the overall value of this product?
1 - Very low value 2 3 4 5 - Very high value
Name Telephone E-mail
B. Buying Experience
C. Pricing & Product Value
D. Contact Information
This questionnaire was created using Perseus SurveySolutions.