Customer Service Satisfaction Survey
Your Personal Information * Required Information
Name: *
Street Address: *
City: *
State: *
Zip Code: *
Telephone Number:
E-mail Address: *
Details of Your Visit
Which location did you shop at?
Did your associate introduce themselves?
Who was your salesperson?
Did you make a purchase?
Please rate your answers to the following questions between 0 and 6 (0 being Strongly Disagree and 6 being Strongly Agree)
Did you feel welcome?

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4
5
6
Did you feel that your sales person cared about your needs?

0
1
2
3
4
5
6
Did you feel that your sales person knew the product?

0
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4
5
6
Please rate your overall experience?

0
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2
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4
5
6
How can we improve your overall shopping experience?
(Maximum characters: 500)
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