Product Feedback Form Product Feedback Form Product Feedback Form

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Product Feedback Form Product Feedback Form Product Feedback Form

Gender: Male/Female Gender: Male/Female Gender: Male/Female

Age: Age: Age:

13 years old and below 13 years old and below 13 years old and below
14 - 20 years old 14 - 20 years old 14 - 20 years old
21 - 45 years old 21 - 45 years old 21 - 45 years old
45 years old and above 45 years old and above 45 years old and above

Occupation:__________ Occupation:__________ Occupation:__________

Instruction: Rate the factors according to the scale Instruction: Rate the factors according to the scale Instruction: Rate the factors according to the scale

Scale: Scale: Scale:

1 - Unsatisfied 2 - Slightly Satisfied 1 - Unsatisfied 2 - Slightly Satisfied 1 - Unsatisfied 2 - Slightly Satisfied

3 - Satisfied 4 - Very Satisfied 3 - Satisfied 4 - Very Satisfied 3 - Satisfied 4 - Very Satisfied

Factors 1 2 3 4 Factors 1 2 3 4 Factors 1 2 3 4


Smell Smell Smell
Taste Taste Taste
Texture Texture Texture
Appearance Appearance Appearance
Color Color Color
Price Price Price

Comment: Comment: Comment:

_____________________________________________ _____________________________________________ _____________________________________________


_____________________________________________ _____________________________________________ _____________________________________________
_____________________________________________ _____________________________________________ _____________________________________________
_____________________________________________ _____________________________________________ _____________________________________________

Signature: Signature: Signature:

___________ ___________ ___________

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