– 1. Is this the first time you have visited the website? yes no  
– 2. What is the PRIMARY reason you came to the site? Did you find what you needed?
Yes, all of it Yes, some of it No, none of it  
– 3. If you did not find any or all of what you needed, please tell us what information you were looking for.
– 4. Please tell us how easy it is to find information on the site.
Very Easy Easy Average Difficult Very Difficult
– 5. What is your overall impression of the site?
– a. Professional
Below Expectations Meets Expectations Exceeds Expectations  
– b. Informative
Below Expectations Meets Expectations Exceeds Expectations  
– c. Visually Pleasing
Below Expectations Meets Expectations Exceeds Expectations  
– d. What is the likelihood that you will visit the website again?
Extremely likely Very likely Moderately likely Slightly likely Not at all likely
– 6. Please add any comments you have for improving the website. We welcome suggestions on specific areas for improvements, features you would like to see added to the site, and examples of what you consider good websites.
– 7. How did you first learn of us? Please select all that apply.
a. Recommendation from another person b. Link from email our site sent you c. Link from another Web site d. TV e. Radio
f. Newspaper g. Magazine h. Internet i. Search engine results j. Other
– 8. How many times in the last 30 days have you visited the website?
Below 5 5-10 10+
– 9. How likely are you to return in the next 30 days?
Extremely likely Very likely Moderately likely Slightly likely Not at all likely
– 10. What was your main reason for visiting our site?
Gather information Curious Other  
– 11. Approximately how long were you at the website?
Less than 3’ 3’ - 5’ 5’ - 10’ 10’+  
– 12. Which Web browser do you use to access the Internet?
Internet Explorer Chrome FireFox Safari Don't know Other
– 13. What is your internet access speed?
ADSL VDSL 3G 4G
– 14. Please indicate your gender Male Female  
– 15. Please select the category that includes your age.
18-24 25-30 31-40 41-55 55+
– 16. Which one of the following ranges includes your total yearly household income before taxes?
Below 10.000€ 10.001€ - 15.000€ 15.001€ – 20.000€ 20.001€ – 25.000€ 25.001€ +
– 17. What is your zip code?