Can We Serve You Better?

  
Thank you for visiting our [Compnay Name] website. We care about your business and notice that you started a shopping cart but did not complete your purchase.

Please take a moment to tell us about your shopping experience so that we can better serve your needs in the future.
 
1. I came to this website to (choose one):
 Make a purchase
 Compare prices
 Just browse
 
2. I didn't complete my purchase because (check all that apply):
 I had shipping questions
 I had product questions
 I had pricing, billing or account questions
 Shopping cart was difficult to use
 Other (please explain in #4 below)
 
3. I plan to (choose one):
 Return and complete my purchase
 Purchase online from another website
 Place my order by phone, fax or mail
 Go shopping at a store
 Cancel my purchase plans
  
4. Please provide us with any additional feedback you have about your online purchasing process. If you'd like us to contact you, please provide your name and contact information.

 
5. Would you like to be contacted about your responses. (If 'Yes,' then please provide your contact information below.)
 Yes
 No
  

First Name:

  

Last Name:

  

Email:

  

Confirm Email:

  

Phone:

  

  

  Check if you would like to be receive our newsletter.


Close Sample Survey Window