This link provides a sample of a customized customer survey: 
Click on this online survey and see the capability of your customized survey. Take 60 seconds to complete this survey and see what your customer would see on your site.
Our clients can customize any of the following points:
Survey customized with graphics and design to match your organization and website
Survey hosted on the organization's website, emailed to the client, or hosted by a domain name if there is no website
Customized introduction paragraph
Required customer information or anonymity
Each location, personnel or department is listed in a drop box, so data can be tracked for the specific destination
Customized key points and values
Customized questions and section names
Customized "thank you" paragraph once the survey is completed by the customer
Customized promotion or coupon that appears once the customer completes the survey. Each location can have a customized promotion/coupon and its optional marketing component.
Once the customer has completed the survey or has printed the promotion/coupon, it will return him/her back to the original home page or link
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Customer Surveys
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