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Customer Feedback Form

Gather detailed feedback about your product or service

Question 1

What's your name?

Question 2

Which product did you purchase?

Product A

Product B

Product C

Other

Question 3

What's your email address?

Question 4

When did you make your purchase?

Question 5

How satisfied are you with our product?

Less SatisfiedMost Satisfied

010

Question 6

How likely are you to recommend us to a friend?

Not LikelyMost Likely

010

Question 7

What could we do to improve our product?

Question 8

Which features did you like? (Select all that apply)