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Grocery Store Customer Experience Survey

Measures how shoppers actually experience your grocery store — shopping frequency, stock availability, checkout, staff, and pricing — and prioritizes which fixes matter most. An AI follow-up interview reconstructs the real story behind a shopper's most recent trip instead of settling for a bare rating.

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Sample questions

A preview of what’s in the template. Every question is editable before you launch.

12 questions · ~7 min
Q01
Message

Thanks for taking a few minutes to tell us about your experience shopping with us! This helps us fix the things that actually bother shoppers. About 4-5 minutes, and every answer is genuinely useful.

Q02
Multiple ChoiceRequired

In the last 30 days, about how many times have you shopped at this grocery store?

  • This is my first visit
  • 1-2 times
  • 3-5 times
  • 6-10 times
  • More than 10 times
Q03
Multiple ChoiceRequired

What's the main reason you choose to shop at this store rather than a competitor?

  • Convenient location
  • Lower prices
  • Better product quality or freshness
  • Wider selection
  • Loyalty program or rewards
  • Faster checkout
  • Better customer service
Q04
MatrixRequired

How satisfied are you with each part of your shopping experience here?

6 rows × 5 columns
  • Store cleanliness
  • Staff friendliness and helpfulness
  • Checkout speed
  • Product availability (items in stock)
  • Price competitiveness
  • +1 more
Columns: Very dissatisfied · Dissatisfied · Neutral · Satisfied · Very satisfied
Q05
Multiple ChoiceRequired

In the last 30 days, how often did you look for an item at this store and find it out of stock?

  • Never
  • Once
  • 2-3 times
  • 4 or more times
Q06
Multiple Choice

Which way do you most often complete your grocery shopping with this store?

  • Shop in person myself
  • Order online for in-store pickup
  • Order online for home delivery
  • A mix of in-person and online
Q07
Opinion ScaleRequired

How likely are you to recommend this grocery store to a friend or family member?

Scale: 0 – 10
Min:Not at all likelyMax:Extremely likely
Q08
Best–Worst Trade-off (MaxDiff)Required

If this store could only make a few of the following changes, which would matter most to you and which would matter least?

  • More checkout lanes or self-checkout kiosks
  • Lower prices on everyday items
  • Wider aisles and easier navigation
  • Better produce quality and freshness
  • More parking spaces
  • Extended store hours
  • Expanded loyalty rewards program
  • Faster online order fulfillment
Pick best & worst per setBest:Would improve my experience the mostWorst:Would improve my experience the least
Q09
AI InterviewRequired

Reconstruct the respondent's most recent shopping trip at this store, focusing on the store attribute they rated lowest in the satisfaction battery above. Ask exactly what happened, how it affected what they bought or how much they spent, and whether it's a recurring issue or a one-time frustration. If they rated everything highly, ask what would make them switch to a competitor and press for a concrete recent example rather than a general opinion.

Q10
Multiple Choice

Which age range do you fall into?

  • Under 18
  • 18-24
  • 25-34
  • 35-44
  • 45-54
  • 55-64
  • 65 or older
  • Prefer not to say
Q11
Multiple Choice

How many people, including yourself, live in your household?

  • 1
  • 2
  • 3
  • 4
  • 5 or more
  • Prefer not to say
Q12
Message

Thanks so much for sharing your grocery shopping experience! Your answers go straight to store operations to help improve stocking, checkout, and service.

What’s included

  • AI follow-ups

    Adaptive probes on open-ended answers that pull out detail a static form would miss.

  • Attention checks

    Built-in safeguards against rushed answers and low-quality respondents.

  • AI-drafted copy

    Wording, ordering, and branching written by the AI — tuned to your research goal.

  • Auto report

    Themes, quotes, and a plain-English summary write themselves once responses come in.

How it compares

We reviewed the closest templates from other survey tools. Here’s what they do well — and where this template goes further.

Why this template

  • Goes beyond a single satisfaction rating by pairing a matrix on checkout, stock, staff, and pricing with an AI follow-up interview that reconstructs the shopper's actual most recent trip.
  • Uses a max-diff question to force-rank potential store changes, giving a clear priority order instead of a flat list of complaints.
  • Captures real shopping behavior (frequency, fulfillment method, out-of-stock encounters) alongside satisfaction and recommendation intent, so results tie experience to concrete operational levers.
  • Every prompt used in the AI follow-up is transparent, and results roll into an auto-generated report — no manual coding of open-ended answers required.

Jotform

Grocery Store Survey Form Template

A ready-to-deploy static form template for grocery store feedback, built on Jotform's drag-and-drop form builder. It's easy to customize and launch quickly, but it collects fixed-choice and text responses without any adaptive questioning based on what a shopper actually says.

What it does well

  • Fielding-ready template usable immediately
  • Highly customizable via Jotform's drag-and-drop builder
  • Broad integration ecosystem typical of Jotform forms

Where it falls short

  • Static question set with no adaptive AI follow-up probing
  • No voice AI interview or guided screen-share task option
  • No published per-response quality scoring methodology

SurveySparrow

Free Grocery Store Survey Template

A free, fielding-ready grocery survey template presented in SurveySparrow's conversational chat-style format. It's approachable and quick to deploy, but the 'conversational' feel is a fixed script rather than a follow-up that adapts to an individual shopper's most recent trip.

What it does well

  • Free to use
  • Conversational chat-style question flow
  • Fielding-ready out of the box

Where it falls short

  • No adaptive AI interview that reconstructs an individual shopper's trip
  • No voice AI interview option
  • No transparent per-response quality scoring

SurveyMonkey

Customer Experience Survey Template & Questions

A general-purpose customer experience template, not specific to grocery retail, aimed at a broad audience across industries. It's fielding-ready with SurveyMonkey's established reporting tools, but it lacks grocery-specific questions like stock availability or fulfillment method, and has no adaptive follow-up capability.

What it does well

  • Fielding-ready and backed by mature reporting/analytics tooling
  • Widely recognized survey brand with broad template library
  • Established benchmarking features for CX metrics

Where it falls short

  • Generic CX questions, not tailored to grocery-specific issues like stock-outs or checkout friction
  • No adaptive AI follow-up interview or voice AI interview option
  • No published per-response quality scoring methodology

Ready to launch?

Open this template in the editor. Every part is yours to change before the first respondent sees it.

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