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Restaurant Allergen Safety & Trust Survey

Measures diners' confidence in restaurant allergen communication, cross-contact prevention, and safety practices. Designed for consumers who manage food allergies or dine with someone who does.

Sample questions

A preview of what’s in the template. Every question is editable before you launch.

19 questions · ~9 min
Q01
Message

Welcome to this survey about food allergy safety in restaurants. We are interested in your honest experiences and opinions — there are no right or wrong answers. Your participation is entirely voluntary and you may stop at any time. All responses are confidential and will be reported only in aggregate. This survey takes approximately 5–7 minutes to complete.

Q02
Dropdown

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

  • I have not dined at a restaurant
  • Less than once per month
  • About once per month
  • 2–3 times per month
  • About once per week
  • A few times per week
  • Daily or almost daily
Q03
Opinion Scale

When dining out in the past 6 months, how often did you or your dining party inform your server about food allergy needs?

Scale: 15
Min:NeverMax:Every time
Q04
Opinion Scale

How clear has allergen information on menus been at the restaurants where you have dined in the past 6 months?

Scale: 17
Min:Not at all clearMax:Extremely clear
Q05
Long Text

Based on your experiences, what could restaurants do to better support safe dining for people with food allergies? Please be as specific as possible.

Q06
Dropdown

What is your age?

  • Under 18
  • 18–24
  • 25–34
  • 35–44
  • 45–54
  • 55–64
  • 65 or older
  • Prefer not to say
Q07
Message

Thank you for completing this survey! Your responses will help improve food allergy safety practices in restaurants. Your answers are confidential and will be reported only in aggregate.

Q08
Multiple Choice

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

  • I have a diagnosed food allergy
  • I have a suspected food allergy or intolerance
  • I avoid certain foods for non-allergy reasons (e.g., dietary preference, religious observance)
  • I regularly dine with someone who has a food allergy
  • None of these
Q09
Opinion Scale

When dining out in the past 6 months, how often did you or your dining party check the menu for allergen information before ordering?

Scale: 15
Min:NeverMax:Every time
Q10
Opinion Scale

Overall, how confident are you that restaurant staff properly handle food allergy requests?

Scale: 17
Min:Not at all confidentMax:Extremely confident
Q11
AI Interview

We'd like to understand your experiences with food allergy safety in restaurants in more depth. Please share your thoughts and our AI moderator will ask a couple of follow-up questions.

Q12
Multiple Choice

Which gender do you identify with?

  • Woman
  • Man
  • Non-binary
  • Prefer not to say
Q13
Multiple Choice

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

  • Peanuts
  • Tree nuts
  • Milk/dairy
  • Eggs
  • Soy
  • Wheat/gluten
  • Fish
  • Shellfish
  • Sesame
  • Sulfites
  • Other (please specify)
  • None of these
Q14
Opinion Scale

When dining out in the past 6 months, how often did you or your dining party ask staff about food preparation methods or cross-contact risks?

Scale: 15
Min:NeverMax:Every time
Q15
Opinion Scale

How much do you trust restaurants in your area to safely prepare meals for diners with food allergies?

Scale: 17
Min:Do not trust at allMax:Trust completely
Q16
Multiple Choice

In which region do you most often dine out?

  • North America
  • South America
  • Europe
  • Africa
  • Middle East
  • Asia
  • Oceania
  • Prefer not to say
Q17
Multiple Choice

Which of the following 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 before arriving
  • Add notes to a reservation
  • Ask to speak with a manager
  • Provide a printed allergy card
  • Use a restaurant's allergy-specific ordering system
  • Other (please specify)
Q18
Multiple Choice

In the past 12 months, what is the most serious allergy-related incident you or your dining party experienced while eating at a restaurant?

  • 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
Q19
Ranking

Please rank the following features from most to least important in making you feel safe when dining with food allergies.

  1. Clearly marked allergens on the menu
  2. Staff explicitly repeat back allergy notes
  3. Server or manager confirms with the kitchen
  4. Evidence of separate prep area or tools
  5. Chef or manager visits the table to discuss
  6. Dedicated fryers or cooking surfaces
Drag to rank

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.