A customer satisfaction questionnaire form is a document that collects records of the levels of satisfaction of customers at the various levels of business and market. Whatever might be the product type, specifications, or price, satisfying the specific demands of customers is very important.

The quality and standards of the product should conform to the demands of customers, and customer satisfaction is the only major parameter that determines the profit or loss of the particular product/service and the success of the business or the company in question. Hence, this questionnaire form should contain questions that help gauge the satisfaction levels of customers effectively.

Customer Satisfaction Questionnaire Form Sample



[Name, address, contact details of the organization]



Name of customer: _____________________

Age: ________                                 Type of customer: _________ [Regular/Occasional]

Address: _______________________

Contact details: ___________________



Q1: How long have you been a customer with [name of the company]?





Q2: How was your first experience [for regular or those who have come earlier at least once]?





Q3: How has the experience been till date?





Q4: How, according to you, has the company evolved over the years?





Q5: What are the strengths and weaknesses of the firm, according to you?





Q6: How have you found the services of the firm to be?

  • Highly satisfactory
  • Good
  • Highly disappointing



Q7: Do you think the company is able to conform to the market demands?


  • Yes
  • No          ________________________________ [give details]



Q8: Do the products/services provided by the company meet your requirements?


  • Yes, totally
  • Somewhat does
  • Not at all



Q9: Where do you find the product to be lagging?


______________________________________ [Mention the essentialities you find missing in the product]



Q10: How satisfied are you with the product/service?


Rate on a scale of 4: _______

[4 – Highly satisfied; 3 – Just about satisfied; 2 – Not really satisfied, needs to improve; 1 – Very poor, highly dissatisfied]