Customer Effort Score Survey Template

Customer effort score survey template with 14 questions covering ease of resolution, effort level, and issue outcome.

Print this ready-made questionnaire and hand it out, then scan and upload the completed forms to read the answers automatically. You can also share the same questionnaire online. The preview below shows the paper version.

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This printable customer effort score survey helps support and service teams measure how hard customers have to work to get an issue resolved, using 14 questions on two pages. It prints on both sides of one sheet and takes about three 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 the standard statement "The company made it easy for me to handle my issue," rated on a seven-point agreement scale, followed by a rating of how easy each step was, from finding a contact to getting an update. A second scale 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.

Paper and web from one template

Use this questionnaire on paper, online, or both, and collect all responses in one place. Open it in a new tab. This is a preview only. Responses are not saved.

Questions in this template

  1. Which channel did you use to contact us?
  2. What was the main reason for your contact?
  3. How many times did you have to reach out before your issue was handled?
  4. Were you transferred to another person or team?
  5. The company made it easy for me to handle my issue.
  6. How much effort did you personally have to put in to get your issue resolved?
  7. How easy or difficult was each step?
  8. Was your issue resolved?
  9. How long did it take to get your issue resolved?
  10. Thinking about the resolution, how much do you agree with the following?
  11. Overall, how satisfied are you with how your issue was handled?
  12. If you would like us to follow up, please share your email address.
  13. What was the hardest part of getting help?
  14. What could we do to make things easier for you?

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