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Customer Satisfaction Assurance

First tell us about YOU

(This is a sample of what your customers might see.
Your customer survey will be customized to your brand.)

Thank you for taking the time to give us your input.

Unless you request to be contacted, your responses will be completely anonymous.

Your input will help us serve you better.

1. How often do you visit, or purchase from, BRAND X?

2. Thinking about your most recent purchase from BRAND X, to what extent do you agree with each of the following?

Space Cell	Strongly disagree	Disagree	Neither	Agree	Strongly agree
The employees were friendly	The employees were friendly: Strongly disagree	The employees were friendly: Disagree	The employees were friendly: Neither	The employees were friendly: Agree	The employees were friendly: Strongly agree
I found what I wanted	I found what I wanted: Strongly disagree	I found what I wanted: Disagree	I found what I wanted: Neither	I found what I wanted: Agree	I found what I wanted: Strongly agree
Checking out was easy	Checking out was easy: Strongly disagree	Checking out was easy: Disagree	Checking out was easy: Neither	Checking out was easy: Agree	Checking out was easy: Strongly agree
Employees were available to assist me	Employees were available to assist me: Strongly disagree	Employees were available to assist me: Disagree	Employees were available to assist me: Neither	Employees were available to assist me: Agree	Employees were available to assist me: Strongly agree
BRAND X has a good variety of products or services	BRAND X has a good variety of products or services: Strongly disagree	BRAND X has a good variety of products or services: Disagree	BRAND X has a good variety of products or services: Neither	BRAND X has a good variety of products or services: Agree	BRAND X has a good variety of products or services: Strongly agree
The employees are knowledgeable	The employees are knowledgeable: Strongly disagree	The employees are knowledgeable: Disagree	The employees are knowledgeable: Neither	The employees are knowledgeable: Agree	The employees are knowledgeable: Strongly agree
BRAND X has great customer service	BRAND X has great customer service: Strongly disagree	BRAND X has great customer service: Disagree	BRAND X has great customer service: Neither	BRAND X has great customer service: Agree	BRAND X has great customer service: Strongly agree
The BRAND X facility was clean	The BRAND X facility was clean: Strongly disagree	The BRAND X facility was clean: Disagree	The BRAND X facility was clean: Neither	The BRAND X facility was clean: Agree	The BRAND X facility was clean: Strongly agree
BRAND X has reasonable prices	BRAND X has reasonable prices: Strongly disagree	BRAND X has reasonable prices: Disagree	BRAND X has reasonable prices: Neither	BRAND X has reasonable prices: Agree	BRAND X has reasonable prices: Strongly agree

3. Please rate your level of agreement with the statement: "For THIS PRODUCT, BRAND X is my primary brand."

Strongly Disagree

Neither Agree nor Disagree

Strongly Agree

4. How likely you are to do each of the following in the next 30 days.

Space Cell	Very unlikely	Unlikely	Neither	Likely	Very likely
Recommend BRAND X	Recommend BRAND X: Very unlikely	Recommend BRAND X: Unlikely	Recommend BRAND X: Neither	Recommend BRAND X: Likely	Recommend BRAND X: Very likely
Make a purchase from BRAND X in-person	Make a purchase from BRAND X in-person: Very unlikely	Make a purchase from BRAND X in-person: Unlikely	Make a purchase from BRAND X in-person: Neither	Make a purchase from BRAND X in-person: Likely	Make a purchase from BRAND X in-person: Very likely
Make a purchase from BRAND X online	Make a purchase from BRAND X online: Very unlikely	Make a purchase from BRAND X online: Unlikely	Make a purchase from BRAND X online: Neither	Make a purchase from BRAND X online: Likely	Make a purchase from BRAND X online: Very likely

5. Can you think of anything that BRAND X could do to improve? (list as many as you like)

6. If you'd like to be contacted, please give us your name and how to contact you in the box below.