A feedback survey form is form which is used to get the feedback of an individual regarding a particular product or a service. This type of form consists of the details regarding the individual, product/services and his satisfaction level with the same.

Sample Feedback Survey Form

Name: ______________

Address: ___________________

Phone Number: _________________

Email Id: __________________________

Store Name from where product is purchased: ___________________

Name of the product purchased: __________________________________

Date of purchase: _____________________________________

Price Paid for the product: __________________________________

Manufacturing and Expiry Date of the Product: __________________________

Have you purchased this product for the first time? _____________________

If you have earlier used this product are you satisfied with its quality? ____________________

Have you recommended this product to your friends and relatives? ________________

What do you like the most about this product? _______________________

Do you find the price of this product appropriate considering its quality? _________________

What changes would you like to see in this product so as to enhance your satisfaction level? ____

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