Experience feedback in both directions: a 1–10 anchor plus ten short ratings on ease, reliability, delight, interface, usage, role, device, feature areas, recommend-worthiness and last interaction type, five written prompts on what they would change and what almost made them leave, and a follow-up interview opt-in with contact field.
Quick answer
Experience feedback in both directions: a 1–10 anchor plus ten short ratings on ease, reliability, delight, interface, usage, role, device, feature areas, recommend-worthiness and last interaction type, five written prompts on what they would change and what almost made them leave, and a follow-up interview opt-in with contact field.
Multiple choice measures what you already thought to ask; verbatims measure what you did not. This questionnaire does both: a 1–10 anchor rating of the overall experience, ten short ratings covering ease, reliability, delight, interface quality, usage frequency, role, primary device, feature areas used, recommend-worthiness and the most recent interaction type, then five written prompts — the experience in their own words, what surprised them, the one thing they would change first, what almost made them give up, and anything else. It closes with a follow-up interview opt-in and a contact field, so the strongest answers can be probed rather than just quoted.
Live form preview — fill it in to see how each answer is captured and exported.
Everything you need to run this template.
A 1–10 number for the overall experience, then the story.
Ease, reliability, delight, interface, usage, role, device, areas, recommend, interaction type.
In their words, what surprised them, one change, what almost made them leave.
Verbatims stay intact per respondent for theming later.
From copy to deliverable in four steps.
Copy the questionnaire into your FormLM workspace — free.
Name the product, service or experience.
Ask close to the experience.
Group verbatims into the themes that emerge.
Pick your role — see how it fits your workflow.
Hear the unnamed issues.
Read the experience in customers’ language.
Pre-scale qualitative capture before surveying.
What makes this template work as a professional deliverable.
A preview of real questions — the full version lets you customize every field.
