Customer Impact & Outcomes Assessment Survey

Thanks for taking a few minutes to reflect on the impact (Replace with your product/service name) has had for you. Your responses are completely confidential and anonymized. This isn't about satisfaction — it's about what's actually changed since you started using it. About 5-6 minutes.

When you first adopted (Replace with your product/service name), what was the main outcome you were hoping to achieve?

• Save time on a recurring task or process
• Reduce costs
• Grow revenue or increase output
• Improve quality, accuracy, or reliability
• Reduce risk or improve compliance
• Improve team or personal capability

To what extent has that outcome actually been achieved so far?

Since you started using it, how much impact has (Replace with your product/service name) had in each of these areas?

Thinking about the overall value you've gotten, distribute 100 points across these areas based on where the biggest real impact has landed.

• Time saved
• Costs reduced
• Revenue or output growth
• Quality or accuracy
• Risk or compliance

If you can, share one concrete number or measurable change (e.g., hours saved per week, % cost reduction, revenue impact) that shows this outcome. Rough estimates are fine.

Reconstruct one specific before-and-after moment that shows the impact this respondent described: what the situation looked like before, what changed after adopting the product, and how they know it was the product (versus other factors) that drove it. If they rated impact as low or gave a vague answer, probe for what would need to be true for them to see real impact, and what's getting in the way today. Anchor on any concrete metric they mentioned and ask how they'd defend that number to a skeptic.

How willing would you be to have this outcome featured as a customer story or reference?

Has this impact been shared with or noticed by leadership or other stakeholders in your organization?

• Yes, formally reported or presented
• Yes, mentioned informally
• Not yet, but I plan to
• No
• Not sure

Roughly how large is your organization? (Prefer not to say is fine)

• 1-10 employees
• 11-50 employees
• 51-200 employees
• 201-1,000 employees
• 1,000+ employees
• Prefer not to say

What's your role in relation to (Replace with your product/service name)?

• Primary day-to-day user
• Manager overseeing its use
• Executive/decision-maker sponsor
• Occasional user
• Other

That's everything — thank you for the detail. Your answers help us understand the real, measurable difference we're making, and may inform a future customer story (we'll always ask before publishing anything).