Things to notice with this example:
● This is a basic questionnaire that formats the options is a variety of ways.
● The ability to enter an email address is driven by the user's agreement.
● The survey is mailed to the given address only if provided.
Close
Thank you for your business. Please help us improve our products and services by completing this short survey.
1. What is your overall satisfaction rating with our company?
5 - Very Satisfied
4 - Somewhat Satisfied
3 - Neither Satisfied Nor Dissatisfied
2 - Somewhat Dissatisfied
1 - Very Dissatisfied
2. Please tell us why you feel that way.
3. How likely are you to recommend our product to a friend or colleague?
5 - Very Likely
4 - Somewhat Likely
3 - Neither Likely Nor Unlikely
2 - Somewhat Unlikely
1 - Very Unlikely
4. Please tell us why you feel that way.
5. Please rate your level of satisfaction with your sales representative in the following areas:
5 - Very Satisfied
4 - Somewhat Satisfied
3 - Neither Satisfied Nor Dissatisfied
2 - Somewhat Dissatisfied
1 - Very Dissatisfied
Responsiveness
5
4
3
2
1
Professionalism
5
4
3
2
1
Understanding of my needs
5
4
3
2
1
6. If you have any additional comments about how we can improve our products and services, please add them here:
7. May we contact you about any of your responses?
Yes
No
If yes, email address:
end of survey