| Scale Type | Topic | Question Text |
| Multiple Choice (single selection) | Demographics | What is your gender? |
| Multiple Choice (single selection) | Demographics | What department do you work in? |
| Multiple Choice (single selection) | Demographics | What is your title? |
| Multiple Choice (single selection) | Demographics | Which racial group do you belong to? |
| Open Ended (fixed length) | Demographics | What is your name? |
| Open Ended (fixed length) | Demographics | Employee's Name? |
| Open Ended (fixed length) | Demographics | Manager's Name? |
| Open Ended (fixed length) | Demographics | Name |
| Open Ended (fixed length) | Demographics | What is your organization's name? |
| Open Ended (fixed length) | Demographics | Department Number: |
| Open Ended (fixed length) | Demographics | What is your title? |
| Open Ended | Demographics | What is your address? (Street, City, State, Zip |
| Open Ended (fixed length) | Demographics | What is your street address |
| Open Ended (fixed length) | Demographics | Address line 1 |
| Open Ended (fixed length) | Demographics | Address line 2 |
| Open Ended (fixed length) | Demographics | What is your phone number? |
| Open Ended (fixed length) | Demographics | Phone Number |
| Open Ended (fixed length) | Demographics | What is your fax number? |
| Open Ended (fixed length) | Demographics | What is your Email address? |
| Multiple Choice (single selection) | Demographics | How long have you been a member of our organization? |
| Multiple Choice (single selection) | Demographics | What is your age? |
| Multiple Choice (single selection) | Demographics | Age |
| Multiple Choice (single selection) | Demographics | What is your length of service in your department? |
| Multiple Choice (single selection) | Demographics | What is your length of service with our company? |
| Multiple Choice (single selection) | Demographics | What geographic region do you live in? |
| Open Ended (fixed length) | Demographics | What state or province do you live in? (Please use the standard postal abbreviation) |
| Open Ended (fixed length) | Demographics | State: (Please use the standard postal abbreviation) |
| Open Ended (fixed length) | Demographics | What city do you live in? |
| Open Ended (fixed length) | Demographics | What is your zip code? |
| Open Ended (fixed length) | Demographics | Zip Code |
| Open Ended (fixed length) | Demographics | What is your home phone number? (Please include area code) |
| Open Ended (fixed length) | Demographics | What is your work phone number? (Please include area code) |
| Yes/No (yes best) | Demographics | Are you a member of management? |
| Multiple Choice (single selection) | Demographics | What is your salary level? |
| Multiple Choice (single selection) | Demographics | What is your level of household income? |
| Multiple Choice (single selection) | Demographics | How many children do you have?(entry) |
| Open Ended (fixed length) | Demographics | How many children do you have?(scale) |
| Open Ended (fixed length) | Demographics | What company do you work for? |
| Open Ended (fixed length) | Demographics | What division do you work for?(choice) |
| Open Ended (fixed length) | Demographics | What division do you work for?(mcse) |
| Disagree - Agree (agree high/5 levels) | Service Satisfaction | We actively seek information from customers like you about services and products. |
| Disagree - Agree (agree high/5 levels) | Service Satisfaction | The company keeps commitments to customers. |
| Disagree - Agree (agree high/5 levels) | Service Satisfaction | Our customers receive high quality service. |
| Poor - Excellent (5 levels) | Service Satisfaction | How would you rate our customer service overall? |
| Never - Always (5 levels) | Service Satisfaction | Do we provide good customer service? |
| Disagree - Agree (agree high/5 levels) | Service Satisfaction | If I were a customer, I would consider this company easy to work with. |
| Disagree - Agree (agree high/5 levels) | Service Satisfactionv | The company has quality partnerships with its customers. |
| Disagree - Agree (agree high/5 levels) | Service Satisfaction | Our customer service record distinguishes our company from our competitors. |
| Never - Always (5 levels) | Service Satisfaction | At this company, the customer comes first. |
| Yes/No (yes best) | Service Satisfaction | Do you enjoy shopping here? |
| Yes/No (yes best) | Service Satisfaction | Do you enjoy doing business with us? |
| Poor - Excellent (5 levels) | Service Satisfaction | Please rate your most recent shopping experience. |
| Yes/No (yes best) | Service Satisfaction | Does our merchandise selection meet your expectations? |
| Disagree - Agree (agree high/5 levels) | Service Satisfaction | I usually find what I need at ___. |
| Poor - Excellent (5 levels) | Service Satisfaction | Please rate the competitiveness of our prices? |
| Disagree - Agree (agree high/5 levels) | Service Satisfaction | Our prices are competitive. |
| Disagree - Agree (agree high/5 levels) | Service Satisfaction | We take complaints seriously. |
| Disagree - Agree (agree high/5 levels) | Service Satisfaction | We respond quickly to complaints. |
| Disagree - Agree (agree high/5 levels) | Service Satisfaction | The company responded satisfactorily to my complaint. |
| Open Ended | Service Satisfaction | If you've had a complaint, how was it handled? |
| Disagree - Agree (agree high/5 levels) | Service Satisfaction | We return telephone calls quickly. |
| Open Ended | Service Satisfaction | How could we improve our service? |
| Poor - Excellent (5 levels) | Service Satisfaction | How would you rate our customer service? |
| Yes/No (yes best) | Service Satisfaction | Are you satisfied with our customer service? |
| Satisfaction (5 levels) | Service Satisfaction | How satisfied are you with our customer service? |
| Disagree - Agree (agree high/5 levels) | Service Satisfaction | Our service usually meets your expectations. |
| Open Ended | Service Satisfaction | What do you think about our service? |
| Open Ended | Service Satisfaction | What is the best thing about our service? |
| Open Ended | Service Satisfaction | Tell us about the quality of our sales staff. |
| Yes/No (yes best) | Service Satisfaction | Did you receive courteous service from our staff? |
| Disagree - Agree (agree high/5 levels) | Service Satisfaction | I received prompt service from the staff. |
| Disagree - Agree (agree high/5 levels) | Service Satisfaction | I received courteous service from the staff. |
| Yes/No (yes best) | Service Satisfaction | Did you receive prompt service from the staff? |
| Never - Always (5 levels) | Service Satisfaction | Is our staff friendly? |
| Disagree - Agree (agree high/5 levels) | Service Satisfaction | Our staff are knowledgeable about our products and services. |
| Open Ended | Service Satisfaction | How could our service be improved? |
| Yes/No (yes best) | Product Satisfaction | Have you used this product in the past? |
| Annual Frequency | Product Satisfaction | How often have you used this product in the past? |
| Open Ended | Product Satisfaction | What did you like about this product? |
| Open Ended | Product Satisfaction | What did you not like about this product? |
| Yes/Uncertain/No (yes best) | Product Satisfaction | Would you recommend this product to others? |
| Annual Frequency | Product Satisfaction | How many times have you used this product? |
| Yes/Uncertain/No (yes best) | Product Satisfaction | Will you continue to use this product in the future? |
| Poor - Excellent (5 levels) | Product Satisfaction | How well did this product meet your expectations? |
| Poor - Excellent (5 levels) | Product Satisfaction | Please rate our product quality. |
| Poor - Excellent (5 levels) | Product Satisfaction | Does the quality of our product meet your expectations? |
| Yes/Uncertain/No (yes best) | Product Satisfaction | Are you satisfied with the quality of our products? |
| Satisfaction (5 levels) | Product Satisfaction | What do you think of our product quality? |
| Yes/No (yes best) | Product Satisfaction | Did the product meet your needs? |
| Open Ended | Product Satisfaction | How could our products be improved? |
| Yes/Uncertain/No (yes best) | Product Satisfaction | Our products are well suited for the purpose they are intended. |
| Yes/Uncertain/No (yes best) | Product Satisfaction | Our products are durable. |
| Satisfaction (5 levels) | Warranty and Repair Service | Are you satisfied with the warranty on our product? |
| Yes/Uncertain/No (yes best) | Warranty and Repair Service | Has our warranty service met your expectations? |
| Yes/No (yes best) | Warranty and Repair Service | Have you had to return for unplanned service? |
| Yes/No (yes best) | Warranty and Repair Service | Was your repair work completed on time? |
| Yes/Uncertain/No (yes best) | Warranty and Repair Service | Was your repair work done to your satisfaction? |
| Disagree - Agree (agree high/5 levels) | Warranty and Repair Service | Repairs were completed for the estimated amount or less. |
| Poor - Excellent (5 levels) | Warranty and Repair Service | Please rate the quality of our repair work. |
| Disagree - Agree (agree high/5 levels) | Warranty and Repair Service | Our repair people listened to your complaints. |
| Disagree - Agree (agree high/5 levels) | Warranty and Repair Service | Our repair people asked appropriate questions to diagnose the problem. |
| Disagree - Agree (agree high/5 levels) | Advertising | Our advertising is effective. |
| Disagree - Agree (agree high/5 levels) | Advertising | Our advertising is honest. |
| Disagree - Agree (agree high/5 levels) | Advertising | Our advertising accurately describes the service or product you purchased. |
| Multiple Choice (multiple selection) | Advertising | Which of our ads do you remember best? |
| Open Ended | Advertising | What do you remember about our advertising? |
| Yes/Uncertain/No (yes best) | Advertising | Was your purchase influenced by our advertising? |
| Open Ended | Advertising | How could we improve our advertising? |
| Disagree - Agree (agree high/5 levels) | Business Environment | Our store/office is pleasant. |
| Open Ended | Business Environment | How could we improve our store/office facilities? |
| Disagree - Agree (agree high/5 levels) | Business Environment | Our rest rooms are clean. |
| Disagree - Agree (agree high/5 levels) | Business Environment | I can usually easily find a parking place. |
| Yes/No (yes best) | Business Environment | Was it easy to find a place to park? |
| Yes/No (yes best) | Business Environment | Is our location convenient? |
| Disagree - Agree (agree high/5 levels) | Business Environment | The lighting is sufficient. |
| Disagree - Agree (agree high/5 levels) | Business Environment | The temperature is comfortable. |
| Disagree - Agree (agree high/5 levels) | Business Environment | Our store/business hours are convenient. |
| Disagree - Agree (agree high/5 levels) | Business Environment | I had to wait in line too long. |
| Satisfaction (5 levels) | Business Environment | What is your satisfaction level with the overall appearance of the rest rooms? |
| Disagree - Agree (agree high/5 levels) | Business Environment | Our display windows are attractive. |
| Satisfaction (5 levels) | Business Environment | What is your satisfaction level with the overall appearance of the display windows? |
| Disagree - Agree (agree high/5 levels) | Business Environment | Our public areas are clean and attractive. |
| Satisfaction (5 levels) | Business Environment | What is your satisfaction level with the overall appearance of public areas? |
| Disagree - Agree (agree high/5 levels) | Business Environment | I am satisfied with the appearance of the department. |
| Satisfaction (5 levels) | Business Environment | What is your satisfaction level with the overall appearance of your department area? |
| Disagree - Agree (agree high/5 levels) | Business Environment | Our store/office is clean and attractive. |
| Satisfaction (5 levels) | Business Environment | What is your satisfaction level with the overall appearance of our store/office? |
| Date | Product Registration | Date of Purchase (mm/dd/yy) |
| Open Ended (fixed length) | Product Registration | Model Number |
| Open Ended (fixed length) | Product Registration | Serial Number |
| Number (no decimal) | Product Registration | Price |
| Multiple Choice (single selection) | Product Registration | Where was this item purchased? |
| Multiple Choice (single selection) | Product Registration | Which of the following most influenced your purchase? (choose one) |
| Multiple Choice (single selection) | Product Registration | Which of the following best describes this purchase? (choose one) |
| Multiple Choice (multiple selection) | Product Registration | What other brands did you consider before purchasing this product? (choose all that apply)(Note: developer must add selections) |
| Multiple Choice (multiple selection) | Product Registration | What other brands of similar products do you own? (choose all that apply) (Note: developer add selections) |
| Multiple Choice (single selection) | Product Registration | Occupation |
| Multiple Choice (single selection) | Product Registration | I am a: |
| Multiple Choice (single selection) | Product Registration | Family Income: |
| Multiple Choice (single selection) | Product Registration | Primary Residence: |
| Multiple Choice (multiple selection) | Product Registration | What credit cards do you use regularly? (check all that apply) |
| Multiple Choice (multiple selection) | Product Registration | Which on line computer service(s) do you use? (check all that apply) |
| Education Level | Product Registration | Highest level of education attained: |
| Multiple Choice (single selection) | Product Registration | Which of the following do you plan to do in the next year? (choose all that apply) |