Satisfaction Survey

Store *

Service: *

	Worst Service	Not Helpful	Average	Helpful	Outstanding Service
	- Worst Service	- Not Helpful	- Average	- Helpful	- Outstanding Service

Cleanliness: *

	Filthy	Dirty	A Few Things Out of Place	Clean	Extremely Clean
	- Filthy	- Dirty	- A Few Things Out of Place	- Clean	- Extremely Clean

	1	2	3	4	5
	- 1	- 2	- 3	- 4	- 5

Product Quality: *

1 being the worst quality and 5 being the best quality

	1	2	3	4	5
	- 1	- 2	- 3	- 4	- 5

Product Selection: *

1 being the worst selection and 5 being the best selection

Price: *

	Affordable	Competitive	Expensive
	- Affordable	- Competitive	- Expensive

With which Department were you most impressed? *

	Produce	Bakery	Grocery	Dairy	Meat	Seafood	Deli/Hot Food	Lotus Cafe	Floral
	- Produce	- Bakery	- Grocery	- Dairy	- Meat	- Seafood	- Deli/Hot Food	- Lotus Cafe	- Floral

I am most likely to return to this Pete's Location: *

	No	Maybe	Yes
	- No	- Maybe	- Yes

	1	2	3	4	5
	- 1	- 2	- 3	- 4	- 5

Overall Store Appearance: *

1 being the worst and 5 being the best

With which product(s) were you most satisfied? *

Which product(s) would you like to see Pete's carry in the future? *

Other comments/suggestions: *

	1	2	3	4	5
	- 1	- 2	- 3	- 4	- 5

What was your overall experience? *

1 being the worst and 5 being the best

Name

Email

Phone

Mobile