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You have a chance to win a Comfort One Shoes gift card worth $500.
 
 
Contact Information
First Name : 
Last Name : 
Address 1 : 
Address 2 : 
City : 
    State     Zip
Phone : 
Email Address : 
 
 
 
Comfort One Shoe Club #:
   
 
 
 
What is the name and description of the associate who assisted you?
   
 
 
 
What is the location where you shopped?
   
 
 
 
What is your overall impression of the store's cleanliness?
 
5 (Exceptional)
 
4 (Above expectations)
 
3 (Met expectations)
 
2 (Below expectations)
 
1 (Very disppointed)
 
 
 
Was the associate wearing a nametag?
 
Yes
 
No
 
 
 
Did the associate greet you within 30 seconds of entering the store?
 
Yes
 
No
 
 
 
If No, check one:
 
Within 31 seconds to 1 minute
 
Within 1 to 3 minutes
 
Within 3 to 5 minutes
 
More than 5 minutes
 
After 5 minutes I approached someone for assistance
 
 
 
Did the associate appeared well-groomed (Men had on ties, Women dressed professionally)?
 
Yes
 
No
 
 
 
If No, check all that apply
 
Clothing seemed wrinkled
 
Clothing seemed dirty, stained
 
Clothing torn, had holes
 
Shirt was un-tucked
 
Associate appeared disheveled, unkempt

 
 
 
Did the associate seem interested in your needs?
 
Yes
 
No
 
 
 
If no, check all that apply
 
Seemed rude or abrupt
 
Seemed rushed or busy
 
Seemed distracted or indifferent
 
Seemed unwilling/uninterested in helping me
 
 
 
Did the associate ask specific questions to determine your needs?
 
Yes
 
No
 
 
 
Did the associate measure both feet?
 
Yes
 
No
 
 
 
When the associate brought out your assortment, did they offer at least 4 other pairs of shoes for you to try on?
 
Yes
 
No
 
 
 
If No, how many shoes were offered?
   
 
 
 
Did the associate bring out insoles and put it in a shoe for you to try?
 
Yes
 
No
 
 
 
Did the associate put both shoes on for you?
 
Yes
 
No
 
 
 
Did the associate check the fit on every shoe?
 
Yes
 
No
 
 
 
Did the associate show you a product that specifically met your needs?
 
Yes
 
No
 
 
 
Did the associate clearly explain the features and benefits of the product?
 
Yes
 
No
 
 
 
Did the associate know the product well enough to answer your questions or found someone else who could help?
 
Yes
 
No
 
 
 
If No, check all that apply
 
Did not answer my question
 
Gave vague or confusing answers
 
Gave inaccurate answers
 
Did not give enough information
 
Did not offer to find someone else

 
 
 
During the interaction, the associate attempted to sell you accessories that match your selected item?
 
Yes
 
No
 
 
 
Did the associate offer that you become a member of the Shoe Club?
 
Yes
 
No
 
 
 
Did the associate hand you your receipt stapled to a thank you card?
 
Yes
 
No
 
 
 
Did the associate carry the bag around the counter and put the bag in your hand with the thank you card and receipt?
 
Yes
 
No
 
 
 
If No, check all that apply
 
Bag was not carried around the corner
 
Bag was not put in hand

 
 
 
Did the associate affirm your decision of the selected items?
 
Yes
 
No
 
 
 
What is your overall impression of the customer service you received? Check one
 
5 Exceptional
 
4 Above Expectations
 
3 Met Expectations
 
2 Below Expectations
 
1 Very disappointed

 
 
 
Would you return to Comfort Shoes based on this visit or recommend this location to others?
 
Yes
 
No
 
 
 
Why or why not?
   
 
 
 
Is there anything else we should know?
   
 
 
 
TICKET #
   
 
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