Q01
Message
All templatesIndustry-Specific
Permission Request Clarity & Consent Experience Survey
Measures how clear, fair, and trustworthy a specific permission or consent request felt to the person being asked — whether it's photo/video release, data sharing, minor participation, or facility access. Built for any organization that formally asks people for permission. An AI follow-up reconstructs the real decision moment, surfacing what almost changed their answer.
Sample questions
A preview of what’s in the template. Every question is editable before you launch.
13 questions · ~7 min
Q02
Multiple ChoiceRequired
Which type of permission were you asked to grant? (Template note: replace these options with the specific permission types your organization requests.)
- Photo or video use
- Personal data or information sharing
- A minor's participation in an activity
- Property or facility access
- (Replace with another permission type)
Q03
Multiple Choice
How did you receive this permission request?
- Paper form
- Mobile app or online portal
- In person or verbally
Q04
Opinion ScaleRequired
How clear was the request about exactly what you were being asked to permit?
Scale: 1 – 7
Min:Very unclearMax:Very clear
Q05
MatrixRequired
Thinking about how this request was handled, how much do you agree with each statement?
4 rows × 5 columns
- The language used was easy to understand
- I was given enough time to decide
- I felt comfortable asking questions before deciding
- I did not feel pressured to say yes
Columns: Strongly disagree · Disagree · Neutral · Agree · Strongly agree
Q06
Multiple ChoiceRequired
What did you ultimately decide?
- I granted full permission
- I granted permission with conditions or limits
- I declined
- I have not decided yet
Q07
Best–Worst Trade-off (MaxDiff)Required
Which of these mattered most when you were deciding whether to grant this permission?
- How clearly the request was explained
- How much I trusted the person or organization asking
- How much time pressure I felt
- The perceived risk to me or others
- The perceived benefit to me or others
- How easy it was to ask questions
- Legal or contractual obligations
- My past experience with similar requests
Pick best & worst per setBest:Mattered mostWorst:Mattered least
Q08
AI Interview
Reconstruct the respondent's decision-making process for this specific permission request: what almost changed their mind, and, if they declined or added conditions, exactly what would need to be different for them to say yes outright. If they granted it quickly and without hesitation, probe what made the request feel trustworthy enough to skip second-guessing.
Q09
Opinion ScaleRequired
How likely are you to grant a future permission request from this same organization?
Scale: 0 – 10
Min:Not at all likelyMax:Extremely likely
Q10
Long Text
What, if anything, would have made this permission request easier or faster to decide on?
Q11
Multiple Choice
Which best describes your role in this request?
- Parent or guardian
- Patient or client
- Employee or staff member
- Property owner or tenant
- Other
Q12
Multiple Choice
What is your age range?
- Under 18
- 18-24
- 25-34
- 35-44
- 45-54
- 55-64
- 65 or older
- Prefer not to say
Q13
Message
That's everything, thank you! Your responses will be used to make our permission requests clearer, fairer, and easier to decide on.
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.
How it compares
We reviewed the closest templates from other survey tools. Here’s what they do well — and where this template goes further.
Why this template
- Includes an AI follow-up interview that reconstructs the actual decision moment and surfaces what almost changed the respondent's answer, not just a static rating
- Covers any type of permission request (photo/video release, data sharing, minor participation, facility access) rather than being locked to one use case like a school permission slip
- Combines a clarity opinion scale, a matrix of fairness/trust statements, and a MaxDiff prioritization question to triangulate what drove the decision, plus a long-text question capturing what would have made the request easier
- Automated per-response quality scoring and an auto-generated report turn open-ended decision narratives into usable findings without manual coding
SurveySparrow
Permission Request Form TemplateThis is a ready-to-field form template aimed at the education sector, designed to collect signed permission (e.g., for field trips or activities) rather than to research how the request itself was experienced. It's a straightforward data-capture form, not a survey built to probe clarity, fairness, or the decision-making process behind granting permission. Good for operational permission collection, but not for measuring consent experience quality.
What it does well
- Purpose-built for education-context permission slips, so it's immediately usable for schools
- Likely simple to set up and send as a standard form
- Part of a broader survey/form platform with standard distribution options
Where it falls short
- Static question set with no adaptive AI follow-up to explore why a respondent almost said no or what nearly changed their decision
- No voice AI interview option or guided screen-share task capability
- No automated per-response quality scoring or transparent prompt methodology, and no built-in matrix/MaxDiff-style question mix to unpack decision drivers
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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