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Product & UX

Form & Checkout Abandonment Diagnostic Survey

Diagnoses why users abandon forms, signups, and checkout flows. Captures the specific step, blockers, and recovery levers to reduce drop-off and improve conversion rates.

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設問の例

テンプレートの内容をプレビューできます。すべての設問は公開前に自由に編集できます。

全18問・約9分
Q01
メッセージ

Welcome, and thank you for taking a few minutes to share your experience. This short survey (approximately 9 minutes) asks about a recent task you started but did not complete on our platform. Your responses are confidential, reported only in aggregate, and will be used to improve the product experience. Participation is entirely voluntary — there are no right or wrong answers, and you may stop at any time.

Q02
プルダウン

When did you last attempt this flow?

  • In the last 24 hours
  • 2–3 days ago
  • 4–7 days ago
  • 8–14 days ago
  • 15–30 days ago
  • More than 30 days ago
  • I don't remember
Q03
選択式

What were the main reasons you did not finish? Select all that apply.

  • Too many steps or took too long
  • Confusing navigation or instructions
  • Price or fees felt too high
  • Trust or security concerns
  • Technical issue or error
  • Payment declined or verification failed
  • Missing required info (e.g., ID, document)
  • Slow load times or performance
  • Wanted to compare options or not ready
  • Prefer to do it on another device
Q04
オピニオンスケール

How likely are you to try completing this flow again in the next 7 days?

スケール: 1 – 7
最小:Not at all likely最大:Extremely likely
Q05
オピニオンスケール

Overall, how clear were the steps in this flow?

スケール: 1 – 7
最小:Not at all clear最大:Extremely clear
Q06
プルダウン

Which region do you live in?

  • Africa
  • Asia
  • Europe
  • Latin America
  • Middle East
  • North America
  • Oceania
  • Prefer not to say
Q07
メッセージ

Thank you for your time — your feedback directly helps us improve this experience.

Q08
選択式

Which type of flow did you start but not finish?

  • Create account / sign up
  • Checkout / purchase
  • Upgrade / subscribe
  • Booking / reservation
  • Add payment method
  • Form submission (e.g., application, quote)
  • Onboarding / setup
  • Feature configuration / settings
  • Search / discovery
Q09
ランク付け

Rank the following barriers by how much they affected your decision not to complete the flow. Drag the biggest barrier to the top.

  1. Price or fees
  2. Technical bug or error
  3. Too much information required
  4. Confusing steps or layout
  5. Payment friction
  6. Privacy or trust concerns
ドラッグして順位を付ける
Q10
選択式

What would most help you complete this flow next time? Select up to 3.

  • Shorter or fewer steps
  • Clearer guidance and examples
  • Save progress and resume later
  • Guest checkout or fewer fields
  • More payment options
  • Installments or pay later
  • Live chat or faster support
  • Better error messages
  • Show total cost and fees earlier
Q11
自由回答（長文）

Based on your experience, is there anything else we should fix or know about this flow?

Q12
プルダウン

What is your age group?

  • 18–24
  • 25–34
  • 35–44
  • 45–54
  • 55–64
  • 65+
  • Prefer not to say
Q13
選択式

Which device or platform were you using?

  • Mobile app
  • Mobile web browser
  • Desktop/laptop web browser
  • Tablet
Q14
AIインタビュー

We'd like to understand more about what got in the way. An AI interviewer will ask you a couple of follow-up questions about your specific experience.

Q15
選択式

Would any of the following incentives motivate you to return and complete the flow? Select all that apply.

  • Small discount or coupon
  • Free shipping or waived fees
  • Bonus feature or trial extension
  • Loyalty points or credit
  • None of these
Q16
選択式

How do you describe your gender?

  • Woman
  • Man
  • Non-binary
  • Prefer not to say
Q17
選択式

Which step best describes where you left off?

  • Selecting items or options
  • Review / cart / summary
  • Sign in or account creation
  • Payment or billing
  • Identity / verification
  • Address or shipping details
  • Confirmation step
  • I don't remember
Q18
選択式

If we were to follow up with you, which channel would you prefer?

  • In-app message
  • Email
  • SMS/text
  • Push notification
  • No follow-up

含まれる機能

  • AIによる深掘り

    自由回答に合わせてAIが追加で質問し、固定のフォームでは拾えない具体的な内容を引き出します。

  • 注意確認設問

    急いだ回答や質の低い回答者を除外する仕組みを標準で備えています。

  • AIが作成する設問文

    文言、設問の順序、条件分岐をAIが調査の目的に合わせて作成します。

  • 自動レポート

    回答が集まると、テーマ、引用、わかりやすい要約が自動で作成されます。

他ツールとの比較

ほかのアンケートツールで最も近いテンプレートを調べました。それぞれの優れている点と、このテンプレートがさらに踏み込んでいる点をまとめています。

このテンプレートを選ぶ理由

  • Pinpoints the exact drop-off step with a dedicated multiple-choice question, then layers a ranking question so respondents prioritize which barriers mattered most — not just which applied.
  • Includes an AI follow-up interview that adaptively probes deeper into whatever blockers a respondent selects, surfacing specifics that fixed-choice questions alone would miss.
  • Goes beyond diagnosis into recovery: dedicated questions on incentives that would motivate a return, preferred follow-up channel, and likelihood to retry within 7 days.
  • Pairs qualitative depth (open-text 'anything else we should fix' question) with quantitative clarity ratings and demographic dropdowns for segment-level analysis, then rolls it all into an auto-generated report.

QuestionPro

Usability Survey For Self-Service Checkouts + Sample Questionnaire Template

This template targets usability of self-service checkout kiosks/machines in a retail setting rather than online form or checkout funnel abandonment specifically, so the fit is partial. It's a static sample questionnaire meant to be customized and fielded, not an adaptive interview. Useful as a general usability feedback starting point, but not built to isolate a specific abandoned step in a multi-page online flow.

優れている点

  • Provides a ready-made sample questionnaire so teams don't start from a blank page
  • Backed by QuestionPro's broader survey distribution and reporting tooling
  • Focuses specifically on checkout usability, a directly related research topic

物足りない点

  • Fixed set of questions with no adaptive AI follow-up to dig into why a specific respondent struggled
  • No per-response quality scoring or transparent prompt methodology published
  • No option for a voice AI interview to capture richer verbal detail on checkout friction

よくあるご質問

「Form & Checkout Abandonment Diagnostic Survey」テンプレートにはどのような設問が含まれていますか？

すぐに使える設問が18問含まれており、最初の設問は次のとおりです：「Welcome, and thank you for taking a few minutes to share your experience. This short survey (approximately 9 minutes) as…」・「When did you last attempt this flow?」・「What were the main reasons you did not finish? Select all that apply.」。すべての設問は上でプレビューでき、自由に編集できます。

このアンケートの回答にはどのくらい時間がかかりますか？

回答者は通常、18問を約9分で回答し終えます。

テンプレートは編集できますか？

はい。公開前であれば、すべての設問、選択肢、順序を編集できます。設問の追加や削除のほか、調査の目的に合わせた作り直しをAIエディターに依頼することもできます。

このテンプレートは無料で使えますか？

はい。エディターで開けば、すぐに編集を始められます。お試しにアカウントは不要で、無料プランでアンケートを公開できます。

公開の準備はできましたか？

このテンプレートをエディターで開いてみてください。最初の回答者が目にする前に、すべてを自由に変更できます。

このテンプレートを使う無料で始める

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