Purchase Intent Survey Template

1. What is your age?

The answer should be a single choice:

1. 18-24
2. 25-34
3. 35-44
4. 45-54
5. 55 or older

2. What is your gender?

The answer should be a single choice:

1. Male
2. Female
3. Prefer not to say

3. What is your occupation?

The answer should be a single choice:

1. Student
2. Professional
3. Retired

4. Are you currently in the market for a new product or service?

The answer should be a single choice:

1. Yes
2. No
3. Undecided

5. What is the primary reason for your purchase?

The answer should be a single choice:

1. Replacement of an old product
2. Upgrade to a new product
3. First-time purchase

6. What is the most important factor in your purchasing decision?

The answer should be a single choice:

1. Price
2. Quality
3. Brand reputation
4. Product features

7. Have you made a similar purchase in the past?

The answer should be a single choice:

1. Yes
2. No

8. What was your overall experience with the previous product or service?

The answer should be a single choice:

1. Highly satisfied
2. Satisfied
3. Neutral
4. Dissatisfied
5. Highly dissatisfied

9. How did you become aware of our product/service?

The answer should be a single choice:

1. Advertising
2. Word of mouth
3. Online search

10. On a scale of 1-5, with 5 being the highest, how familiar are you with our product/service?

The answer should be a single choice:

1. 1 (Not at all familiar)
2. 2
3. 3
4. 4
5. 5 (Extremely familiar)

11. Have you used our product/service before?

The answer should be a single choice:

1. Yes
2. No

12. How would you rate your overall experience with our product/service?

The answer should be a single choice:

1. Highly satisfied
2. Satisfied
3. Neutral
4. Dissatisfied
5. Highly dissatisfied

13. What suggestions do you have for improving our product/service?

The answer should be a multi line text input.

14. Would you recommend our product/service to a friend or colleague?

The answer should be a single choice:

1. Yes
2. No
3. Undecided