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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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Sample questions

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

18 questions · ~4 min
Q01
Long Text

Welcome, and thank you for taking a few minutes to share your experience. This short survey (approximately 4–5 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
Long Text

When did you last attempt this flow?

Q03
Multiple Choice

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

Q04
Long Text

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

Q05
Long Text

Overall, how clear were the steps in this flow?

Q06
Long Text

Which region do you live in?

Q07
Long Text

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

Q08
Multiple Choice

Which type of flow did you start but not finish?

Q09
Long Text

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

Q10
Multiple Choice

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

Q11
Long Text

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

Q12
Long Text

What is your age group?

Q13
Multiple Choice

Which device or platform were you using?

Q14
AI Interview

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
Multiple Choice

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

Q16
Multiple Choice

How do you describe your gender?

Q17
Multiple Choice

Which step best describes where you left off?

Q18
Multiple Choice

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

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.

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