User Feedback Questionnaire


A user feedback questionnaire as the name suggests is used primarily to receive feedback from end users or customers regarding a specific products or service. The objective of using a user feedback questionnaire is to receive concrete answers from users or customers that can help an organization or service provider to make important changes in their overall marketing or promotional strategies. The feedback also helps the organizations to serve the end user or customer better in the long run and in the face of competition.

Sample User Feedback Questionnaire:

Name of the Participant: _____________________________

Gender: _________________ (M/F)   Age: ______________

Address: ______________________________________  City:_______________

State: __________________  Zip: ________________

Email: _____________________________

Phone Number: ____________________________

  • Which of the following platforms do you rely on mostly for purchasing a product or signing up for a service?

a)      The Internet

b)      E-Stores

c)      Brand retail outlets

d)     Supermarkets

e)      Brand agents

f)       Phone shopping

  • Are you satisfied with the services offered by the above mentioned platforms? If “No” then please mention your reason

a)      Yes

b)      No

c)      Not sure

d)     Reason for dissatisfaction:___________________________________________

  • How often do you shop at retail outlets for a product / service?

a)      Once a week

b)      Only on weekends

c)      Once in a fortnight

d)     2-3 times a month

e)      More than 3 times a month

f)       Once in several months

  • Which retail outlets do you visit most often and why?

a)      _________________________

b)      _________________________

c)      _________________________

d)     _________________________

e)      _________________________

  • Are you satisfied with the responsiveness of the staff working at the above retail outlets?

a)      Extremely satisfied

b)      Somewhat satisfied

c)      Satisfied

d)     Neutral

e)      Dissatisfied

f)       Somewhat dissatisfied

g)      Extremely dissatisfied

  • Are you satisfied with the customer service support offered at the above retail outlets?

a)      Extremely satisfied

b)      Somewhat satisfied

c)      Satisfied

d)     Neutral

e)      Dissatisfied

f)       Somewhat dissatisfied

g)      Extremely dissatisfied

Category: User Questionnaire

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