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Create a customer feedback Google Form

Ask about one recent experience, then separate the satisfaction rating from what caused it. This example combines a labeled 1–5 scale with two open questions and an optional follow-up contact.

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Who this is for

Teams deciding what to improve after a customer has used a service or product.

Example form

Plain text to adapt

Customer Experience Feedback
> Please think about your most recent experience with us.

*How satisfied were you? [scale] low=1 high=5 low_label="Very dissatisfied" high_label="Very satisfied"

What worked well? [paragraph]

What is the one thing we should improve? [paragraph]

May we contact you about your feedback? [multiple_choice]
- Yes
- No

Email (optional — only if you would like a reply) [text]

Parsed preview

Customer Experience Feedback

Please think about your most recent experience with us.

  1. How satisfied were you? [scale] · Required

    1 — Very dissatisfied · 5 — Very satisfied

  2. What worked well? [paragraph]
  3. What is the one thing we should improve? [paragraph]
  4. May we contact you about your feedback? [multiple_choice]
    • Yes
    • No
  5. Email (optional — only if you would like a reply) [text]

About this example

  • Five questions; the same scale anchors should be used across comparable rounds.
  • The email field is optional and asks for an address only if the customer would like a reply. It stays visible regardless of the contact-permission answer.

Before you start

  • Replace “us” with the service or experience being reviewed and specify the relevant time period.
  • Decide who will read feedback, how you will prioritize one change, and when you will revisit it.
  • If you do not need follow-up, remove both the contact-permission and email questions.

Create your form

  1. Open the example and name the specific experience in the title or introduction.
  2. Review the labeled scale and open questions in Check & Preview. Keep the same scale when comparing future rounds.
  3. Create the Google Form in your own account, check its settings and respondent view, then share it with the intended customers.

Limits and settings to check

  • SurveysAI creates the form; it does not analyze responses or automatically select an improvement. Review answers in Google Forms.
  • The form is not automatically anonymous. An optional email and account settings can identify a respondent.
  • The contact question does not hide the email field conditionally. State clearly that leaving an email is optional and only requested if follow-up is welcome.

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