Grocery Store Feedback Form
Grocery Store Feedback Form
Please provide your feedback to help us improve your shopping experience; all responses are confidential and used for quality improvement only.
Name
Enter the full name of the purchaser.
Please provide your email address for the invoice.
Phone Number
Provide your contact phone number.
Address
Date of Visit
How often do you shop at our store?
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First time
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Once a week
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2-3 times a week
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Once a month
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Rarely
Rate your satisfaction with the following:
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Category |
Very Satisfied |
Satisfied |
Neutral |
Unsatisfied |
Very Unsatisfied |
|---|---|---|---|---|---|
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Store Cleanliness |
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Product Availability |
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Product Quality |
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Customer Service |
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Prices |
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Checkout Speed |
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Overall Shopping Experience |
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Did you find everything you were looking for?
If No, please specify what you couldn't find:
How would you rate our associates?
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Category |
Excellent |
Good |
Fair |
Poor |
|---|---|---|---|---|
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Helpfulness |
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Knowledge |
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Friendliness |
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Would you recommend our store to others?
Additional Comments:
Thank you for submission!
We appreciate you taking the time to submit.
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