Q01
Long Text
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Retail Receipt Format & Data Privacy Preferences Survey
Measures in-store shoppers' preferences for digital versus paper receipts and their comfort with retailer data use, informing receipt digitization and privacy strategy decisions.
Sample questions
A preview of what’s in the template. Every question is editable before you launch.
24 questions · ~4 min
Q02
Multiple Choice
In the past 30 days, approximately how many in-store shopping trips have you made?
Q03
Multiple Choice
When you have a choice, which receipt format do you generally prefer?
Q04
Long Text
Overall, how satisfied are you with the receipt format you typically receive?
Q05
Multiple Choice
Which of the following would you be comfortable sharing with a retailer to receive digital receipts? Select all that apply.
Q06
Multiple Choice
Which of the following controls would make you more comfortable with digital receipts? Select all that apply.
Q07
Long Text
Based on your responses in this survey, please share any additional thoughts or feelings about receipt formats or how retailers handle your data.
Q08
Long Text
What is your age range?
Q09
Long Text
Thank you for completing this survey. Your responses have been recorded and will be kept confidential. If you have any questions, please contact the research team.
Q10
Multiple Choice
For your most recent in-store purchase, what type of receipt did you receive, if any?
Q11
Multiple Choice
In the past 3 months, which digital receipt channels have you used? Select all that apply.
Q12
Long Text
How likely are you to switch to (or continue using) digital receipts as your primary format in the next 6 months?
Q13
Long Text
How comfortable are you with a retailer using your receipt data to send you personalized offers or coupons?
Q14
Long Text
How much do you trust the retailer you shop at most often to protect your receipt data?
Q15
AI Interview
We'd like to explore your thoughts on receipt preferences and data privacy in a bit more depth. Please share openly — there are no right or wrong answers.
Q16
Multiple Choice
Which of the following best describes your gender?
Q17
Multiple Choice
If you ever choose paper receipts, what are the main reasons? Select all that apply.
Q18
Long Text
How comfortable are you with a retailer tracking your purchase history over time using receipt data?
Q19
Long Text
Which region do you currently live in?
Q20
Multiple Choice
If you ever choose digital receipts, what are the main reasons? Select all that apply.
Q21
Long Text
How comfortable are you with a retailer using your receipt data to process returns or warranty claims?
Q22
Long Text
What is the highest level of education you have completed?
Q23
Long Text
How comfortable are you with a retailer sharing your receipt data with third-party partners?
Q24
Multiple Choice
What is your current employment status?
What’s included
AI follow-ups
Adaptive probes on open-ended answers that pull out detail a static form would miss.
Attention checks
Built-in safeguards against rushed answers and low-quality respondents.
AI-drafted copy
Wording, ordering, and branching written by the AI — tuned to your research goal.
Auto report
Themes, quotes, and a plain-English summary write themselves once responses come in.
Ready to launch?
Open this template in the editor. Every part is yours to change before the first respondent sees it.