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Cart Abandonment & Checkout Issues Survey Template

Reduce cart abandonment by diagnosing checkout drop-offs. Capture payment failures, address validation errors, and form friction. 6-8 min survey.

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

Sample Survey Items

Q1
Multiple Choice
Where did you attempt to check out?
  • Mobile app
  • Mobile web browser
  • Desktop/laptop web browser
  • Tablet web browser
Q2
Dropdown
When was your most recent checkout attempt?
  • Within the last 7 days
  • 8–14 days ago
  • 15–30 days ago
  • More than 30 days ago
Q3
Multiple Choice
Which payment methods did you try during that checkout? (Select all that apply)
  • Credit/debit card
  • PayPal
  • Apple Pay
  • Google Pay
  • Bank transfer
  • Buy Now, Pay Later (e.g., Klarna/Affirm)
  • Gift card or store credit
Q4
Multiple Choice
Did your payment go through?
  • Yes, on the first try
  • Yes, after multiple tries
  • No, I abandoned checkout
  • No, I contacted support and completed later
Q5
Matrix
How easy or difficult were these payment steps?
RowsVery easySomewhat easyNeither easy nor difficultSomewhat difficultVery difficult
Entering card details
3‑D Secure/OTP step
Payment method not available
Card declined
Applying promo/gift code
Network timeout or slow loading
Q6
Numeric
How many times did you retry payment during that session?
Accepts a numeric value
Whole numbers only
Q7
Rating
Overall, how easy or difficult was entering your shipping/billing address?
Scale: 11 (star)
Min: Very difficultMax: Very easy
Q8
Multiple Choice
Which address fields caused issues, if any? (Select all that apply)
  • Street address line 1
  • Address line 2 / Apartment / Unit
  • City
  • State / Province / Region
  • Postal / ZIP code
  • Country selector
  • Phone number
  • Name fields
Q9
Multiple Choice
Did you use autofill for address details?
  • Yes, and it worked
  • Yes, but it caused issues
  • No
Q10
Matrix
For each item, how severe were validation or error issues?
RowsNo issueSlight issueModerate issueMajor issueBlocked me
Card number validation
Expiry or CVV validation
Postal/ZIP code format rules
Phone number format rules
Required field errors
Error message clarity
Q11
Opinion Scale
Error messages helped me resolve problems without leaving checkout.
Range: 1 10
Min: Strongly disagreeMid: NeutralMax: Strongly agree
Q12
Long Text
If you remember any specific error codes/messages or what blocked you, please describe.
Max 600 chars
Q13
Ranking
Rank the top three blockers you encountered (drag to rank).
Drag to order (top = most important)
  1. Payment method unavailable
  2. Address validation rejected correct info
  3. Card declined or 3‑D Secure failed
  4. Form usability (auto-fill, cursor focus, field order)
  5. Promo/gift code issues
  6. Slow loading or timeouts
  7. Unclear or missing error messages
Q14
Numeric
Approximately how many minutes did checkout take from cart to confirmation (or stopping)?
Accepts a numeric value
Whole numbers only
Q15
Rating
Overall satisfaction with the checkout experience.
Scale: 11 (star)
Min: Very dissatisfiedMax: Very satisfied
Q16
Multiple Choice
Attention check: To confirm you are paying attention, please select "I am paying attention."
  • I am paying attention
  • I am not paying attention
  • Prefer not to answer
Q17
Dropdown
Age
  • 18–24
  • 25–34
  • 35–44
  • 45–54
  • 55–64
  • 65+
  • Prefer not to say
Q18
Multiple Choice
Gender
  • Woman
  • Man
  • Non-binary
  • Prefer not to say
Q19
Dropdown
Region
  • North America
  • Europe
  • Asia-Pacific
  • Latin America
  • Middle East
  • Africa
  • Prefer not to say
Q20
Multiple Choice
Highest level of education completed
  • Less than high school
  • High school or equivalent
  • Some college or vocational training
  • Bachelor's degree
  • Master's degree
  • Doctorate
  • Prefer not to say
Q21
Multiple Choice
Current employment status
  • Full-time
  • Part-time
  • Self-employed
  • Student
  • Unemployed
  • Retired
  • Prefer not to say
Q22
Long Text
Any other feedback or suggestions to improve the checkout experience?
Max 600 chars
Q23
AI Interview
AI Interview: 2 Follow-up Questions on Checkout Issues
AI InterviewLength: 2Personality: [Object Object]Mode: Fast
Q24
Chat Message
Thanks for your time—your feedback will help us improve checkout!

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