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Survey6 fields

Customer Satisfaction Survey

Measure customer satisfaction with ratings, open feedback, and NPS-style questions.

Spam protectionEmail notificationsAI sales agentSubmission dashboardNo backend needed

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Exactly what visitors will see on your site

Customer Satisfaction Survey

What you'll collect

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

Copy the Code

Choose HTML for static sites or React for component-based apps. Replace YOUR_FORM_ID with your Flowqen endpoint ID.

<form
action="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>

What is a Customer Satisfaction Survey?

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.

Frequently Asked Questions

Common questions about survey form templates.

Start with this Customer Satisfaction Survey

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