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Hello:
You are invited to participate in our survey [Project Description Here]. In this survey, approximately [Approximate Respondents] people will be asked to complete a survey that asks questions about [General Survey Process]. It will take approximately [Approximate Time] minutes to complete the questionnaire.

Your participation in this study is completely voluntary. There are no foreseeable risks associated with this project. However, if you feel uncomfortable answering any questions, you can withdraw from the survey at any point. It is very important for us to learn your opinions.

Your survey responses will be strictly confidential and data from this research will be reported only in the aggregate. Your information will be coded and will remain confidential. If you have questions at any time about the survey or the procedures, you may contact [Name of Survey Researcher] at [Phone Number] or by email at the email address specified below.

Thank you very much for your time and support. Please start with the survey now by clicking on the Continue button below.

 
 
 
How long have you been a customer?
 
Less than 6 months
 
6 months to less than 1 year
 
1 year to less than 3 years
 
3 years to less than 5 years
 
5 years or more
 
 
 
What products/services of ours do you use?
 
{PRODUCT/SERVICE 1}
 
{PRODUCT/SERVICE 2}
 
{PRODUCT/SERVICE 3}
 
{PRODUCT/SERVICE 4}
 
{PRODUCT/SERVICE 5}
 
Other
 

 
 
How frequently do you purchase our products/services?
Don't purchase Once a year or less Every 7-12 months Every 2-6 months Once a month Every 2-3 weeks Once or more a week
{PRODUCT/SERVICE 1}
{PRODUCT/SERVICE 2}
{PRODUCT/SERVICE 3}
{PRODUCT/SERVICE 4}
{PRODUCT/SERVICE 5}
 
 
How important were each of the following attributes in your decision to purchase our product/service?
Not important Somewhat important Neutral Somewhat important Very important
Pricing
Ease of use
Quality of products/services
Responsiveness of support staff
Store location
 
 
 
Do you purchase mainly in the physical retail store or online?
 
Physical retail store
 
Online store
 
Purchase from both equally
 
 
 
Which city do you live in?
 
{CITY YOU SERVICE 1}
 
{CITY YOU SERVICE 2}
 
{CITY YOU SERVICE 3}
 
Other
 
 
 
 
Please indicate your gender.
 
Male
 
Female
 
Prefer not to answer
 
 
 
Which range includes your age?
 
Younger than 18
 
18 - 24
 
25- -34
 
35 - 44
 
45 - 54
 
55 - 64
 
65 or older
 
Prefer not to answer