Restaurant Food Allergy & Allergen Safety Survey Template

Collect diner feedback on allergen communication, cross-contact, and safety practices in restaurants. Customizable, ready to use; 5–7 minutes.

What's Included

AI-Powered Questions

Intelligent follow-up questions based on responses

Automated Analysis

Real-time sentiment and insight detection

Smart Distribution

Target the right audience automatically

Detailed Reports

Comprehensive insights and recommendations

Template Overview

Questions

AI-Powered

Smart Analysis

Ready-to-Use

Launch in Minutes

This professionally designed survey template helps you gather valuable insights with intelligent question flow and automated analysis.

Sample Survey Items

Dropdown

In the past 3 months, how often have you dined at restaurants?

Daily or almost daily
A few times per week
About once per week
2–3 times per month
About once per month
Less than once per month

Multiple Choice

Which of the following describe your dining in the past 12 months? (Select all that apply)

I have a diagnosed food allergy
I have a suspected allergy or intolerance
I avoid certain foods for non-allergy reasons
I regularly dine with someone who has a food allergy
None of these

Multiple Choice

Which allergens do you or your usual dining party avoid? (Select all that apply)

Peanuts
Tree nuts
Milk/dairy
Eggs
Soy
Wheat/gluten
Fish
Shellfish
Sesame
Sulfites
None of these

Matrix

When dining out in the past 6 months, how often did you or your party do the following?

Rows	Never	Rarely	Sometimes	Often	Always	Not applicable
Tell the server about the allergy	•	•	•	•	•	•
Ask for the allergy to be noted on the order	•	•	•	•	•	•
Ask about cross-contact prevention	•	•	•	•	•	•
Verify ingredients with a manager or chef	•	•	•	•	•	•
Check menu/allergen info online before visiting	•	•	•	•	•	•

Opinion Scale

In the past 6 months, how confident are you that staff understand and handle allergy requests?

Range: 1 – 10

Min: Not confidentMid: NeutralMax: Very confident

Rating

How clear has menu allergen information been where you dined in the past 6 months?

Scale: 11 (star)

Min: Very unclearMax: Very clear

Multiple Choice

Which ways do you prefer to communicate allergy needs to a restaurant? (Select all that apply)

Tell the server in person
Add notes to an online order
Call ahead
Add notes to a reservation
Ask to speak with a manager
Provide a printed allergy card

Multiple Choice

Attention check: To confirm you are paying attention, please select “Often” below.

Never
Rarely
Sometimes
Often
Always

Multiple Choice

In the past 12 months, did you or your party experience any allergy-related incidents while dining out?

No incidents
Suspected cross-contact but no symptoms
Mild reaction managed without medication
Reaction requiring medication (e.g., antihistamine, epinephrine)
Severe reaction requiring urgent medical care
Prefer not to say

Q10

Ranking

Please rank the features that make you feel safest when dining with allergies (most to least important).

Drag to order (top = most important)

Clearly marked allergens on the menu
Staff explicitly repeat back allergy notes
Server or manager confirms with the kitchen
Evidence of separate prep area or tools
Chef/manager visits the table to discuss
Dedicated fryers or cooking surfaces

Q11

Long Text

What could restaurants do to better support safe allergy dining? Please be specific.

Max 600 chars

Q12

Dropdown

What is your age?

Under 18
18–24
25–34
35–44
45–54
55–64
65 or older
Prefer not to say

Q13

Multiple Choice

Which gender do you identify with?

Woman
Man
Non-binary
Prefer not to say

Q14

Multiple Choice

Where do you primarily dine?

North America
South America
Europe
Africa
Middle East
Asia
Oceania
Prefer not to say

Q15

Multiple Choice

What is the highest level of education you have completed?

Less than high school
High school or equivalent
Some college/Associate degree
Bachelor’s degree
Postgraduate degree
Prefer not to say

Q16

Multiple Choice

What is your current employment status?

Employed full-time
Employed part-time
Self-employed
Unemployed and looking for work
Student
Homemaker/Caregiver
Retired
Unable to work
Prefer not to say

Q17

Long Text

Any final comments about dining with food allergies?

Max 600 chars

Q18

AI Interview

AI Interview: 2 Follow-up Questions on Dining with Food Allergies

AI InterviewLength: 2Personality: [Object Object]Mode: Fast

Q19

Chat Message

Thank you for participating! Your feedback helps improve allergy-safe dining.

Frequently Asked Questions

What is QuestionPunk?

QuestionPunk is a lightweight survey platform for live AI interviews you control. It's fast, flexible, and scalable—adapting every question in real time, moderating responses across languages, letting you steer prompts, models, and flows, and even generating surveys from a simple prompt. Get interview-grade insight with survey-level speed across qual and quant.

How do I create my first survey?

Sign up, then decide how you want to build: let the AI generate a survey from your prompt, pick a template, or start from scratch. Choose question types, set logic, and preview before sharing.

How can I share surveys with my team?

Send a project link so teammates can view and collaborate instantly.

Can the AI generate a survey from a prompt?

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How long does support typically take to reply?

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Can I export survey results?

Absolutely. Export results as CSV straight from the results page for quick data work.

Restaurant Food Allergy & Safety Survey Template

Collect customer feedback on allergen communication, cross-contact prevention, menu labeling, and staff response to improve restaurant safety and guest trust.

Ready to use