Q01
Message
All templatesIndustry-Specific
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.
Sample questions
A preview of what’s in the template. Every question is editable before you launch.
12 questions · ~7 min
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 TemplateA 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 TemplateA 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 & QuestionsA 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
Frequently asked questions
What questions are in the “Grocery Store Customer Experience Survey” template?
The template includes 12 ready-to-use questions, starting with: “Thanks for taking a few minutes to tell us about your experience shopping with us! This helps us fix the things that act…” · “In the last 30 days, about how many times have you shopped at this grocery store?” · “What's the main reason you choose to shop at this store rather than a competitor?”. The full set is previewed above, and every question is editable.
How long does this survey take to complete?
Respondents typically finish the 12 questions in about 7 minutes.
Can I customize this template?
Yes — every question, answer option, and the ordering is editable before you launch. You can add or remove questions, or ask the AI editor to rework the survey around your research goal.
Is this template free to use?
Yes. Open it in the editor and start customizing right away — no account required to try it, and the free plan covers launching your survey.
Ready to launch?
Open this template in the editor. Every part is yours to change before the first respondent sees it.
Related templates
More studies on similar topics.
Industry-Specific
Post-Vaccination Experience and Side Effect Tracker
Tracks how patients felt in the days after a vaccination — side effect severity, how well staff set expectations, and overall satisfaction — for clinics, pharmacies, and health systems monitoring vaccine programs. An AI follow-up interview reconstructs what actually happened physically and logistically for patients with rougher experiences, going beyond a checkbox symptom list.
View templateIndustry-Specific
Retail Store Visit Experience Evaluation
Captures how shoppers rate a specific store visit — cleanliness, staff, stock, layout, checkout — plus overall satisfaction and likelihood to recommend or return. An AI follow-up interview digs into the real friction behind any low ratings, like a specific stockout or a bad checkout interaction, so store ops teams know exactly what to fix.
View templateIndustry-Specific
In-Store Shopper Trip and Checkout Experience Survey
Captures what shoppers came to buy, how they navigated the store, what they did when an item was missing, and how checkout felt — with an AI follow-up that digs into the real reasoning behind substitution choices and navigation friction. Built for retail insights and category management teams.
View templateIndustry-Specific
Supermarket Shopping Attitudes and Habits Survey
Captures how shoppers choose, evaluate, and switch between grocery stores and channels — price sensitivity, loyalty behavior, and channel mix — for retail and CPG researchers. An AI follow-up interview digs into the real story behind a shopper's most recent store choice or channel switch, beyond what a closed question can capture.
View templateIndustry-Specific
Online Retailer Shopping Experience Evaluation Survey
Measures how customers rate an online retailer on price, selection, site experience, shipping, and service, plus what drives loyalty versus defection to a competitor. An AI follow-up interview reconstructs the specifics of a recent order to explain the ratings instead of leaving them as abstract scores.
View templateIndustry-Specific
Fast Food Customer Experience & Loyalty Survey
Measures satisfaction with speed, accuracy, food quality, and value at a quick-service restaurant, plus what drives repeat visits and recommendations. An AI follow-up interview reconstructs exactly what happened on the customer's most recent visit — especially when something went wrong — instead of settling for a star rating.
View template