This printable NPS survey fits on a single card and captures a Net Promoter Score in five quick questions, so you can measure customer loyalty at the point of service without an email or app. The card takes under a minute to complete and gives you a clear score to track over time.
What this survey measures
The core question asks how likely each customer is to recommend you on a 0 to 10 scale, which sorts responses into promoters, passives, and detractors and produces your Net Promoter Score. An open comment box captures the main reason behind each score, a repeat-purchase question gauges future intent, and a contact opt-in with an email line lets you follow up with people who agree to hear from you.
How to use it on paper
Hand the card to customers at checkout, place a stack near the exit with a drop box, or include one with a receipt or delivery. Customers fill the checkboxes and the score circle with a blue or black pen. Collect the completed cards and scan them in batches: PaperSurvey reads the marked answers with optical mark recognition and converts the handwritten comments and email addresses to text automatically, so your score updates without any manual data entry.
Customize this template
Add your logo, reword the questions to match your product or service, or add and remove questions to suit your goals. The paper layout reflows automatically as you edit, and every card you print stays scannable.
Preview the PDF above, or use this template to start measuring customer loyalty today.