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Rate Your Experience Form Template

Gather valuable insights to enhance your customer service

Do you struggle to collect feedback that leads to real improvement? The Rate Your Experience Form Template is designed for businesses like yours that want to gain actionable insights from customer responses. With this template, you can effectively gauge satisfaction, identify areas for enhancement, and foster stronger customer relationships, all while ensuring compliance with accessibility standards. Discover how easy it is to gather meaningful feedback and enhance your services with a few clicks.

Date of your experience
Location, store, or order reference (optional)
Which of the following did you use today?
In person (store or office)
Website
Mobile app
Phone support
Email support
Live chat
Delivery or service visit
Other
Please Specify:
Overall, how satisfied were you with your experience?
Very dissatisfied
Dissatisfied
Neutral
Satisfied
Very satisfied
How likely are you to recommend us to a friend or colleague?
0 Not at all likely
1
2
3
4
5 Extremely likely
How would you rate the overall quality of what you received?
Poor
Below average
Average
Good
Exceptional
How easy was it to complete what you came to do?
Very difficult
Difficult
Neutral
Easy
Very easy
How would you rate the helpfulness of our staff or support?
Poor
Below average
Average
Good
Exceptional
Not applicable
How satisfied were you with the timeliness of service?
Very dissatisfied
Dissatisfied
Neutral
Satisfied
Very satisfied
Not applicable
How satisfied were you with the value for money?
Very dissatisfied
Dissatisfied
Neutral
Satisfied
Very satisfied
Not applicable
If you had an issue, was it resolved?
Yes
No
Did not have an issue
What went well for you today?
What could we improve?
Full name (optional)
Email (optional)
Is it okay to contact you about your feedback?
Yes
No
How did you hear about us?
Search engine
Social media
Friend or family
Advertisement
Walk-in or passing by
Existing customer
Other
Please Specify:
{"name":"Date of your experience", "url":"https://www.quiz-maker.com/QPREVIEW","txt":"Date of your experience, Location, store, or order reference (optional), Which of the following did you use today?","img":"https://www.quiz-maker.com/3012/images/ogquiz.png"}
Paper art illustration depicting a rate your experience form template for FormCreatorAI article

When to use this form

In product, service, or event follow-ups, use this form right after a key moment. It fits checkout, support chats, store visits, and post-demo emails. You get quick sentiment to spot friction, celebrate wins, and plan fixes. For digital touchpoints, pair it with the Website evaluation form to capture page-level issues. If you ship software, compare results with the Software satisfaction survey form to track updates. Retail teams can trigger it after purchases, as seen in the Tractor supply survey form example. Product, CX, and ops teams benefit most, turning scores and comments into prioritized action.

Must Ask Rate Your Experience Questions

  1. How satisfied were you with your overall experience?

    A simple 1-5 or 1-10 scale gives you a fast health check. It helps you track trends over time and see if recent changes moved the needle.

  2. What worked well for you today?

    Positive specifics show what to keep and amplify. You can reuse customer language in training and messaging.

  3. What did not meet your expectations?

    This surfaces friction points in the customer journey. Clear examples guide your next fixes and reduce repeat issues.

  4. How likely are you to recommend us to a friend or colleague?

    Use a 0-10 scale, similar to the Net promoter score form, to measure loyalty. It identifies promoters and detractors so you can follow up with the right actions.

  5. How easy was it to complete your task?

    Ease of use predicts repeat behavior and churn risk. This directs UX and process improvements that remove effort for your customers.

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