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Purchase Satisfaction Form
Please fill the form below
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Full Name:
*
First Name
*
Last Name
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Mobile No:
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Invalid phone number.
The value must be less than or equal to 20
Email id:
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Please enter valid email address
*
Gender:
Male
Female
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Satisfied
Dissatisfied
Neutral
Overall, how satisfied were you with your purchase experience today
Please tell us why you feel that way:
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Very likely
Neutral
Not likely at all
How likely are you to recommend our site to a friend, family member, or colleague
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Very likely
Neutral
Not likely at all
How likely are you to purchase from us the next time you are in the market for the type of product you purchased today
Please tell us how our site compares to other sites that sell similar products for each of the items below. If you did not experience that part of our site, please select N/A:
Much worse
About the same
Much better
N/A
Overall organization/navigation
Clarity of product information
Ease of ordering process
Product selection
Pricing
Shipping options
Ease of finding how to contact us
Customer service
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Do you have any suggestions on how we might improve our site and the purchase experience:
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*
What prompted your visit to our site today? Please select all that apply:
Researching product information
Interested in purchasing products/services
Looking for contact information
Looking for customer support
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*
How did you learn about our site? Please select all that apply:
Link from email our site sent you
Link from another Web site
TV
Radio
Newspaper
Magazine
Social Media
Search engine results
Recommendation from another person
Others
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Please specify:
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Which of the following describes your Internet connection speed right now:
Dial up modem
Wireless/Broadband
Other High speed
Don't know
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Where do you typically access the Internet? Please select all that apply:
Home
Work
School
Library
Cafe
Mobile Phone
Computer tablet(ex Ipad)
Others
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Please specify:
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*
Approximately how frequently do you make online purchases:
Once per week
2 to 3 times per week
Once per month
6 times per year
As few times per year
Once per year or less
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Please select the category that includes your age:
Under 18
18-24
25-34
35-44
45-54
55-64
65 or Above
Prefer Not to Answer
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Which one of the following ranges includes your total yearly household income before taxes:
Under $20000
$20000 - $30000
$30000 - $40000
$40000 - $50000
$50000 - $75000
$75000 - $100000
$100000 - $150000
$150000 or more
Prefer Not to Answer
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Comments:
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