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How would you rate your mood today on a scale from 1-10, 1 representing extreme sadness/anger and 10 representing extreme happiness?
 
1
 
2
 
3
 
4
 
5
 
6
 
7
 
8
 
9
 
10
 
Other
 
 
 
After viewing the following ad, 
Very Unimportant Somewhat Unimportant Neutral Somewhat Important Very Important
Pricing
Ease of Use
Responsiveness of support staff
Quality
 
 
 
What does [COMPANY NAME] do that makes it unique from its competitors?
   
 
 
 
How long have you used our products?
 
For less than 1 month
 
For 1 to 6 months
 
For 7 months up to 1 year
 
For 1 to 2 years
 
For more than 2 years
 
 
 
How likely are you to do business with us again?
 
Very likely
 
Somewhat likely
 
Neutral
 
Somewhat unlikely
 
Very unlikely
 
 
 
Is there anything we could do to improve your experience as a customer?