Feedback Survey Template

A survey is a kind of a medium which is used by organizations and individuals to understand the mindset of the general public and gather information from their feedback.  A survey is an effective tool which helps people to fathom various facts which are otherwise difficult to comprehend.  A survey of this kind may either have multiple choice questions or subjective questions. Many surveys have both kinds of questions as well. To frame a good feedback survey, one must keep in mind certain points and understand the main framework of a survey. To help you with it, we have the following feedback survey template which can be used as a reference document.

Sample Feedback Survey Template:

Name of respondent: ________________ [enter the name of the person answering the survey]

Contact number: ____________ [enter the contact number of the respondent]

Address of respondent: ____________ [enter the address of the respondent]

Age of respondent: ___________ [enter age of the respondent]

Please take out a few minutes to answer the following given feedback survey questions in the spaces provided below.

Q1.  What are your views about ______________ [mention the thing about which views are being asked for]

a)      ______________[give the options in points]

b)      ______________

c)      ______________


Q2. Do you agree that _______________ [enter a quality of the entity to ask for the respondent’s response]

a)      ______________[give the options in points]

b)      ______________

c)      ______________

d)     ______________

Q3. Give your opinion about _______________ [mention the thing for which the opinion is asked for]

__________________________________ [give space for the respondent to give his answer]

Q4. If you were given a chance, then what would you change about _______ [mention the entity about which the survey is being conducted].


Q5. How satisfied are you with _____________ [mention the entity about which satisfaction level of the respondent is being asked for]?

a)      Very satisfied

b)      Satisfied

c)      Not satisfied

d)     ___________[give other options, if any]

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