A customer feedback form questionnaire is an official means to present questions to the customer group of a particular company or business, and collect reviews for products/services. It is designed in a way that the feedback of customers can be collected in the form in answer to the questions in the document (questionnaire). Customers are the direct target group for whom products or services are designed and delivered to; hence, it is important to have a clear idea of how they are reacting to the same.

Such a questionnaire helps gather information that throw light on the needs and demands of the customers as well. Thus a customer feedback form questionnaire is a very effective way of collecting details, and needs to be designed skillfully so as to produce the maximum output.

Customer Feedback Form Questionnaire Sample:



[Organization’s letterhead]

Name of customer: ________________

Permanent address: _________________________

Telephone number: _________________                                Email ID: _____________

Age: _____ years                                               Sex: ______ [Male/Female]



Q1: Which are the products/services that you have availed of?




Q2: How did the product fit your purpose?

[Tick the box corresponding to the appropriate answer]



It was perfect




Could have been better



Very poor



[any suggestions you would like to put]


Q3: How was the delivery of the product?




Very much on time and excellent service



A bit late





Too late; very bad service



Q4: How was the packaging of the product?



Well packed and safely delivered


Slightly loose packing but was fine when delivered



Very poor packing; the product was found damaged when delivered


Q5: How did you choose the product?


I chose it from the shop


From the website


Heard from a friend and ordered over phone


Q6: Please give a detailed description of the product/service and also give us your valuable suggestions.





Any specific areas you would want us to look after and improve:

  1. _____________________


  1. _____________________


  1. _____________________