Conversational form
Customer feedback survey
Six questions, about ninety seconds. Short enough that people finish it, structured enough that the answers are worth reading.
The form itself
A static copy of the finished form, exactly as it renders. Nothing here can be filled in or submitted, so read it as a reference and build your own from the button above.
Every field, and what it collects
The complete field list, in the order respondents meet it.
- How satisfied were you with your visit today?Single choiceRequired
- Options: Very satisfied · Satisfied · Neither satisfied nor dissatisfied · Dissatisfied · Very dissatisfied
- How likely are you to recommend us to a friend or colleague?Single choiceRequired
- 0 means not at all likely, 10 means extremely likely.
- Options: 0 · 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10
- What is the main reason for your score?Long textRequired
- What went well?Multiple choice
- Options: The staff · The speed · The quality · The value · The atmosphere · Nothing in particular
- What is the one thing we could do better?Long text
- If you would like a reply, what is your email?Short text
- Leave it blank to stay anonymous.
What makes this form work
The NPS question keeps its exact wording
"How likely are you to recommend us to a friend or colleague" on a 0 to 10 scale. Change the words or the scale and the number stops being comparable to anyone else's.
A score is always followed by a why
One rating question paired with one open question is the whole trick. The score tells you the trend, the sentence tells you what to fix.
Six questions, and it says so
The welcome screen promises ninety seconds and the progress bar proves it. Completion falls off a cliff somewhere past five minutes, and most surveys quietly cross it.
Questions people ask
What is the difference between NPS and CSAT?
CSAT asks how satisfied someone was with a specific experience, usually on a five point scale. NPS asks how likely they are to recommend you on a 0 to 10 scale, and measures the relationship rather than the moment. This survey uses both.
How many questions should a feedback survey have?
Three to five for a transactional survey, five to eight for a relationship one. Completion drops sharply as length grows, and a finished short survey beats an abandoned long one.
Should feedback be anonymous?
Let people choose. The last question here asks for an email only if they want a reply, which gets you follow-ups without suppressing the honest, anonymous answers.
Build your own in about a minute
The button below opens the form generator with this use case already described. Change the wording to match your own, generate, then edit anything you like.
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