Customer Satisfaction Survey Template Question Title * 1. How likely is it that you would recommend Burgess Illustrationz to a friend or colleague? NOT AT ALL LIKELY EXTREMELY LIKELY 0 1 2 3 4 5 6 7 8 9 10 0 1 2 3 4 5 6 7 8 9 10 OK Question Title * 2. Overall, how satisfied or dissatisfied are you with Burgess Illustrationz? Very satisfied Somewhat satisfied Neither satisfied nor dissatisfied Somewhat dissatisfied Very dissatisfied OK Question Title * 3. Which of the following words would you use to describe our services? Select all that apply. Reliable High quality Useful Unique Good value for money Overpriced Impractical Ineffective Poor quality Unreliable OK Question Title * 4. How well does our services meet your needs? Extremely well Very well Somewhat well Not so well Not at all well OK Question Title * 5. How would you rate the quality of the service? Very high quality High quality Neither high nor low quality Low quality Very low quality OK Question Title * 6. How would you rate the value for money of the service? Excellent Above average Average Below average Poor OK Question Title * 7. How responsive have we been to your questions or concerns about our services? Extremely responsive Very responsive Somewhat responsive Not so responsive Not at all responsive Not applicable OK Question Title * 8. How long have you been a customer of Burgess Illustrationz? This is my first purchase Less than six months Six months to a year 1 - 2 years 3 or more years I haven't made a purchase yet OK Question Title * 9. How likely are you to purchase any of our services again? Extremely likely Very likely Somewhat likely Not so likely Not at all likely OK Question Title * 10. Please enter your contact information if you like so we can send you promotions. Name City/Town State/Province -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming Email Address Phone Number OK DONE