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Mobility & Lifestyle Customer Feedback Form
Please let us know your thoughts about your recent purchase from Mobility & Lifestyle. All completed forms are entered into a monthly prize draw to win a £25 Mobility & Lifestyle voucher!
Your Name
*
Which Mobility & Lifestyle did you purchase your goods from?
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Please select
Atherstone Co-Op
Bedworth Co-Op
Hinckley
Loughborough
Melton Mowbray
Nuneaton
Rugby
Tamworth Co-Op
Mobility & Lifestyle Online
Sale ID
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This can be found below the date on your receipt
FOR EACH QUESTION BELOW, PLEASE SELECT THE OPTION WHICH BEST MATCHES YOUR OPINION
I received a good level of customer service in the Mobility & Lifestyle Outlet
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Strongly Agree
Agree
Neither Agree Nor Disagree
Disagree
Strongly Disagree
The member of staff showed a good level of product knowledge
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Strongly Agree
Agree
Neither Agree Nor Disagree
Disagree
Strongly Disagree
The Mobility & Lifestyle Outlet had an excellent range of goods
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Strongly Agree
Agree
Neither Agree Nor Disagree
Disagree
Strongly Disagree
I was shown how to use the goods I purchased
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Strongly Agree
Agree
Neither Agree Nor Disagree
Disagree
Strongly Disagree
The goods I have chosen suit my needs
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Strongly Agree
Agree
Neither Agree Nor Disagree
Disagree
Strongly Disagree
DELIVERY
Did you collect your goods or were they delivered to you?
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Collected
Delivered
If your goods were delivered, how would you rate the delivery time?
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Faster than I expected
As I expected
Slower than I expected
I collected my goods from the store
If your goods were delivered, would you agree that the Delivery Engineer was polite and informative?
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Strongly Agree
Agree
Neither Agree Nor Disagree
Disagree
Strongly Disagree
I collected my goods from the store
FOR EACH QUESTION BELOW, PLEASE SELECT THE OPTION WHICH BEST MATCHES YOUR OPINION
I am likely to use Mobility & Lifestyle again
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Strongly Agree
Agree
Neither Agree Nor Disagree
Disagree
Strongly Disagree
I would recommend Mobility & Lifestyle to my friends and family
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Strongly Agree
Agree
Neither Agree Nor Disagree
Disagree
Strongly Disagree
Overall, how would you rate the service you received from Mobility & Lifestyle?
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Excellent
Good
Satisfactory
Less Than Satisfactory
Poor
Any Additional Comments?
Please provide us with your email address so we can notify you if you win the prize draw
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Would you like to receive the latest news and offers from Mobility & Lifestyle via email?
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Yes
No
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