Customer Effort Score Survey Template

Customer effort score survey template with 4 questions covering ease of resolution, effort level, and issue outcome.

Use this template

Copy this template into your account, then customize it to suit your needs.

This printable customer effort score survey helps support and service teams measure how hard customers have to work to get an issue resolved, using 4 questions on a single page. It prints on one sheet and takes about two minutes to complete, so you can hand it to every customer instead of relying on email surveys that most people ignore.

What this survey measures

The core of the customer effort score is a short agreement grid, led by the standard statement "The company made it easy for me to handle my issue," alongside prompts about repeating information and clarity of the steps. A pick-one question captures the effort level customers felt they had to put in, and a simple resolution question records whether the issue was fully resolved, unresolved, or only partly handled. An open comment box invites specific suggestions for removing friction the fixed questions may miss.

How to use it on paper

Hand the survey to customers at the end of a service interaction, at a help desk, or include it with a shipped order or repair. Customers fill the checkboxes with a blue or black pen. Collect the completed forms and scan them in batches: PaperSurvey reads the checkbox answers with optical mark recognition and converts the handwritten comments to text automatically, so results appear in your dashboard without any manual data entry.

Customize this template

Add your company logo, reword the statements to match your service channel, or add and remove questions to fit your process. The paper layout reflows automatically as you edit, and every copy you print stays scannable.

Preview the PDF above, or use this template to start measuring customer effort today.

Questions in this template

  1. Please rate how much you agree with the following statements.
  2. How much effort did you personally have to put in to get your issue resolved?
  3. Was your issue resolved?
  4. What could we do to make things easier for you?

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