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Name
   
 
 
 
What products did you purchase?
   
 
 
 
What did you like about the products?
   
 
 
 
What did you dislike?
   
 
 
 
How can we improve our products?
   
 
 
 
Would you buy from us again? If no, please explain.
   
 
 
 
What is your gender?
 
Male
 
Female
 
Prefer not to answer
 
 
 
Which of the following categories describes your age?
 
Younger than 18
 
18-24
 
25-34
 
35-44
 
45-54
 
55-64
 
65 or older
 
Prefer not to answer
 
 
 
Anything else you'd like to share?
   
 
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