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CUSTOMER SATISFACTION SURVEY
Full Name
Email
Street Address
City
State
Phone Number
Date Of Birth (dd/mm/yyyy)
 
Product Type:
Cotrac Basic Cotrac Basic Plus Cotrac Gold Cotrac Gold Plus
 
1. How long have you used our product/service?
Less than 6 months
More than 6 months but less than 1 year
1-3 years
Over 3 years
Never used
 

2. How often do you use our product/service?
Once per week or more
2 to 3 times per month
Once per month
Less than once per month
 
3. Please list the top three (3) reasons you initially became a customer of COTEKIT in order of importance.
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4. Overall, how satisfied were you with our product/service?
5 - Very satisfied
4 - Somewhat satisfied
3 - Neither satisfied nor dissatisfied
2 - Somewhat dissatisfied
1 - Very dissatisfied
 
5. Please tell us why you feel that way :
 
6. How satisfied are you with following characteristics of our product/service?
 
5-Very satisfied
4-Somewhat satisfied
3-Neither satisfied nor dissatisfied
2-Somewhat satisfied
1- Very dissatisfied
Quality
Price
Purchase experience
Installation or first use experience
Usage experience
After purchase service (customer service, etc)
Repeat purchase experience
 
7. Thinking of your most recent experience with our product/service, how much do you agree with the following statements?
 
5-Strongly agree
4-Somewhat agree
3-Neither agree nor disagree
2-Somewhat disagree
1- Strongly disagree
Product/service was worth the purchase price
Product/service does what it claims
Product/service does what I need
Product/service is easy to use
Product/service is competitively priced
 
8. What do you like about our product/service? :
 
9. What did you dislike about our product/service? :
 
10. Thinking of similar products/services offered by other companies, how would you compare our product/service offered to them?
Much better
Somewhat better
About the same
Somewhat worse
Much worse
Don't know
 
11. Would you purchase our product/service again?
Definitely
Probably
Not sure
Probably not
Definitely not
 
12. Why do you feel that way about purchasing our product/service again?
 
13. Would you recommend our product/service to colleagues or contacts within your industry?
Definitely
Probably
Not sure
Probably not
Definitely not
 
14. Why do you feel that way about recommending our product/service?
 
15. What suggestions do you have to improve our product/service?
 
16. Please rate your level of agreement with the following statements (10-1 scale with 10 being completely agree, 5 being neutral, and 1 being completely disagree):
 
I believe COTEKIT deserves my loyalty
1 2 3 4 5 6 7 8 9 10
 
Over the past year, my loyalty to COTEKIT has grown stronger
1 2 3 4 5 6 7 8 9 10
 
COTEKIT values people and relationships ahead of short-term goals
1 2 3 4 5 6 7 8 9 10
 
Thank you for your time and valuable input.
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