The Customer Market Research Survey template is a five-point scale style customer
survey designed to provide a company with a convenient means to: (1) create customer
survey questions and answers, (2) compile customer responses, and (3) save time and
money. The template can be tailored to meet any and all of a company's market
research survey needs. This form contains standard clauses. Additionally, it can be
customized to provide for any additional industry specific language that may be
necessary. Use this form when conducting customer market research surveys.
COMPANY NAME AND LOGO
[INSERT DESCRIPTION OF SURVEY] MARKET RESEARCH SURVEY
[Insert Company Name] is conducting a [Insert Description of Survey] survey to [Describe the
Purpose/Objective(s)] of the survey. We value your opinion and would greatly appreciate it if you would
take a few moments to complete the survey below.
Instructions: [Provide Specific and Simple Instructions on How to Complete the Survey].
TOPIC/SUBJECT #1: [Insert Topic/Subject Here]
QUESTION #1: [Insert Statement Here]
Always
Often
Sometimes
Rarely
Never
QUESTION #2: [Insert Statement Here]
Always
Often
Sometimes
Rarely
Never
QUESTION #3: [Insert Statement Here]
Always
Often
Sometimes
Rarely
Never
QUESTION #4: [Insert Statement Here]
Always
Often
Sometimes
Rarely
Never
© Copyright 2011 Docstoc Inc. 2
COMPANY NAME AND LOGO
[INSERT DESCRIPTION OF SURVEY] MARKET RESEARCH SURVEY
TOPIC/SUBJECT #2: [Insert Topic/Subject Here]
QUESTION #1: [Insert Question Here]
Answer #1
Answer #2
Answer #3
Answer #4
Answer #5
QUESTION #2: [Insert Question Here]
Answer #1
Answer #2
Answer #3
Answer #4
Answer #5
QUESTION #3: [Insert Question Here]
Answer #1
Answer #2
Answer #3
Answer #4
Answer #5
QUESTION #4: [Insert Question Here]
Answer #1
Answer #2
Answer #3
Answer #4
Answer #5
QUESTION #5: [Insert Question Here]
Answer #1
Answer #2
Answer #3
Answer #4
Answer #5
© Copyright 2011 Docstoc Inc. 3
COMPANY NAME AND LOGO
[INSERT DESCRIPTION OF SURVEY] MARKET RESEARCH SURVEY
TOPIC/SUBJECT #3: [Insert Topic/Subject Here]
QUESTION #1: [Insert Question Here]
Excellent
Above Average
Average
Below Average
Very Poor
QUESTION #2: [Insert Question Here]
Excellent
Above Average
Average
Below Average
Very Poor
QUESTION #3: [Insert Question Here]
Excellent
Above Average
Average
Below Average
Very Poor
QUESTION #4: [Insert Question Here]
Excellent
Above Average
Average
Below Average
Very Poor
QUESTION #5: [Insert Question Here]
Excellent
Above Average
Average
Below Average
Very Poor
THANK YOU FOR YOUR TIME AND PARTICIPATION!
© Copyright 2011 Docstoc Inc. 4
COMPANY NAME AND LOGO
[INSERT DESCRIPTION OF SURVEY] MARKET RESEARCH SURVEY
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THE MATERIALS, E