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Sample - Product Follow-up Survey
XXX Company

This is a follow-up about the product we sent to you or you download from our Web Site. Please complete this form and send it us. We appreciate your support.
 
Note: Marked with * are  required.
Section 1
1.1 Did you receive the product we sent you? *
Yes No

If No, Skip to question 2.1

1.2 When did you receive it?

1.3 Have you used the product?
Yes No

If No, Skip to question 2.1

1.4 How many times have you used it?
1.5 Overall, how would you rate the product on the following features?
  Excellent Very Good Good Fair Poor
Feature 1:
Feature 2:
Feature 3:
1.6 Which of the following best describes how likely you would be to buy the product?
Definitely Probably Not Sure
Unlikely very unlikely
1.7 What do you like about our product?
1.8 What do you dislike about our product?
Section 2
2.1 Your Contact Information
Name: *
Company:
Email: *
Phone: *


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