Measure customer satisfaction with ratings, open feedback, and NPS-style questions.
Exactly what visitors will see on your site
Every field in this template, ready to use out of the box.
Name (optional)
text · optional
Email (optional)
email · optional
Overall Satisfaction
select · required
What did we do well?
textarea · optional
What can we improve?
textarea · optional
Would you recommend us?
select · required
Choose HTML for static sites or React for component-based apps. Replace YOUR_FORM_ID with your Flowqen endpoint ID.
<formaction="https://flowqen.com/api/f/YOUR_FORM_ID"method="POST"class="max-w-xl mx-auto rounded-[30px] border border-stone-200 bg-white px-6 py-7 shadow-[0_24px_80px_rgba(43,31,25,0.08)] sm:px-8"><h2 class="text-2xl font-semibold tracking-tight text-stone-900 mb-6">Customer Satisfaction Survey</h2><div class="space-y-4"><div><label class="mb-1.5 block text-sm font-medium text-stone-700">Name (optional)</label><input type="text" name="name" class="w-full rounded-2xl border border-stone-300 bg-stone-50 px-4 py-3 text-sm text-stone-900 outline-none transition focus:border-[#E14E3A] focus:ring-4 focus:ring-[#E14E3A]/12" placeholder="Jane Doe" /></div><div><label class="mb-1.5 block text-sm font-medium text-stone-700">Email (optional)</label><input type="email" name="email" class="w-full rounded-2xl border border-stone-300 bg-stone-50 px-4 py-3 text-sm text-stone-900 outline-none transition focus:border-[#E14E3A] focus:ring-4 focus:ring-[#E14E3A]/12" placeholder="jane@example.com" /></div><div><label class="mb-1.5 block text-sm font-medium text-stone-700">Overall Satisfaction</label><select name="overall_satisfaction" class="w-full rounded-2xl border border-stone-300 bg-stone-50 px-4 py-3 text-sm text-stone-900 outline-none transition focus:border-[#E14E3A] focus:ring-4 focus:ring-[#E14E3A]/12" required><option value="">Select...</option><option value="1 - Very Dissatisfied">1 - Very Dissatisfied</option><option value="2 - Dissatisfied">2 - Dissatisfied</option><option value="3 - Neutral">3 - Neutral</option><option value="4 - Satisfied">4 - Satisfied</option><option value="5 - Very Satisfied">5 - Very Satisfied</option></select></div><div><label class="mb-1.5 block text-sm font-medium text-stone-700">What did we do well?</label><textarea name="what_we_did_well" rows="4" class="w-full rounded-2xl border border-stone-300 bg-stone-50 px-4 py-3 text-sm text-stone-900 outline-none transition focus:border-[#E14E3A] focus:ring-4 focus:ring-[#E14E3A]/12 resize-none" placeholder="Tell us what you liked..."></textarea></div><div><label class="mb-1.5 block text-sm font-medium text-stone-700">What can we improve?</label><textarea name="what_to_improve" rows="4" class="w-full rounded-2xl border border-stone-300 bg-stone-50 px-4 py-3 text-sm text-stone-900 outline-none transition focus:border-[#E14E3A] focus:ring-4 focus:ring-[#E14E3A]/12 resize-none" placeholder="Share your suggestions..."></textarea></div><div><label class="mb-1.5 block text-sm font-medium text-stone-700">Would you recommend us?</label><select name="would_recommend" class="w-full rounded-2xl border border-stone-300 bg-stone-50 px-4 py-3 text-sm text-stone-900 outline-none transition focus:border-[#E14E3A] focus:ring-4 focus:ring-[#E14E3A]/12" required><option value="">Select...</option><option value="Definitely">Definitely</option><option value="Probably">Probably</option><option value="Not sure">Not sure</option><option value="No">No</option></select></div></div><!-- Honeypot (spam protection) --><div style="display:none"><input type="text" name="_gotcha" style="display:none" /></div><button type="submit" class="mt-6 w-full rounded-2xl bg-[#E14E3A] py-3 text-sm font-semibold text-white transition hover:bg-[#c9432f]">Submit Survey</button></form>
A customer satisfaction survey form template helps you measure how happy your customers are with your product or service. This HTML form combines rating scales, open-ended feedback fields, and a recommendation question to give you a complete picture of customer sentiment. Use it after purchases, support interactions, or on a regular cadence.
Common questions about survey form templates.
Other free templates in the same category.
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