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Stakeholder Interview Eligibility Screener

Pre-qualifies potential stakeholder interviewees by assessing role fit, recent domain involvement, and scheduling availability for 45–60 minute research sessions.

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Sample questions

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

22 questions · ~10 min
Q01
Message

Welcome! This brief screener (approximately 10 minutes) helps us confirm your eligibility, recent experience, and availability for a 45–60 minute research session. Your responses are voluntary and confidential — they will be used solely to determine fit for this study and will not be shared outside the research team. There are no right or wrong answers. By continuing, you confirm that you are at least 18 years old and consent to your responses being used for participant selection purposes.

Q02
Multiple Choice

Which option best describes your relationship with the organization conducting this study?

  • Internal (employee or contractor)
  • External (customer, partner, or prospect)
  • Other (please specify)
Q03
Multiple Choice

In the past 3 months, how often have you completed tasks or used tools related to [RESEARCH TOPIC]?

  • Daily
  • Weekly
  • Monthly
  • Rarely
  • Never
Q04
Multiple Choice

Are you able to participate in a single 10 minutes online session?

  • Yes
  • No
  • Depends on timing
Q05
Multiple Choice

What is your age range?

  • 18–24
  • 25–34
  • 35–44
  • 45–54
  • 55–64
  • 65+
  • Prefer not to say
Q06
Long Text

Is there anything else we should know about your role, recent experience, or scheduling before we follow up?

Q07
Dropdown

Which department do you primarily work in?

  • Engineering / IT
  • Product / Design / UX
  • Marketing
  • Sales / Business Development
  • Customer Support / Success
  • Operations
  • Finance / Legal
  • HR / People
  • Executive / Leadership
  • Other (please specify)
Q08
Multiple Choice

Which tools or platforms do you commonly use for [RESEARCH TOPIC]-related work? (Select all that apply)

  • Zoom
  • Microsoft Teams
  • Slack
  • Google Workspace
  • Microsoft 365
  • Jira / Trello / Asana
  • CRM (e.g., Salesforce, HubSpot)
  • None of these
  • Other (please specify)
Q09
Dropdown

What is your primary time zone?

  • Pacific (US/Canada)
  • Mountain (US/Canada)
  • Central (US/Canada)
  • Eastern (US/Canada)
  • Atlantic (Canada/Caribbean)
  • UK / Ireland (GMT/BST)
  • Central Europe (CET)
  • Eastern Europe (EET)
  • Middle East (GST/AST)
  • East Africa (EAT)
  • West/Central Africa (WAT/CAT)
  • India / Sri Lanka (IST)
  • Southeast Asia (ICT/WIB)
  • East Asia — China/Singapore (CST/SGT)
  • Japan / Korea (JST/KST)
  • Australia / New Zealand (AEST/NZST)
  • Latin America (various)
  • Other
Q10
Multiple Choice

Which best describes your gender identity?

  • Woman
  • Man
  • Non-binary
  • Self-describe (please specify)
  • Prefer not to say
Q11
Message

Thank you for your time — we'll review your responses and follow up within 5 business days if there's a fit. If you have any questions in the meantime, please contact the research team.

Q12
Multiple Choice

What is your current relationship to the organization?

  • Current customer
  • Former customer
  • Partner
  • Prospect evaluating
  • Vendor / Supplier
  • Other (please specify)
Q13
Long Text

Briefly describe a recent task you completed related to [RESEARCH TOPIC] (within the past 30 days).

Q14
Multiple Choice

Which times generally work for you in the next 14 days? (Select all that apply)

  • Weekdays: Morning
  • Weekdays: Afternoon
  • Weekdays: Evening
  • Weekends: Morning
  • Weekends: Afternoon
  • Not available in the next 14 days
Q15
Dropdown

Where do you primarily reside?

  • North America
  • Central America / Caribbean
  • South America
  • Western Europe
  • Eastern Europe
  • Middle East
  • North Africa
  • Sub-Saharan Africa
  • South Asia
  • East Asia
  • Southeast Asia
  • Central Asia
  • Oceania
  • Prefer not to say
Q16
Multiple Choice

In the past 6 months, how much influence have you had on product- or process-related decisions at your organization?

  • None
  • Minimal — I provide input but don't decide
  • Moderate — I influence some decisions
  • Significant — I drive most decisions in my area
  • Primary decision-maker
Q17
AI Interview

Based on the task you described, we'd like to understand a bit more about your recent experience and how it relates to this study.

Q18
Multiple Choice

Are you comfortable being audio/video recorded for research analysis?

  • Yes
  • No
Q19
Multiple Choice

What is the highest level of education you have completed?

  • Secondary / High school or equivalent
  • Some college / Associate degree
  • Bachelor's degree
  • Postgraduate / Professional degree
  • Prefer not to say
Q20
Multiple Choice

Have you participated in a research session with this organization in the past 60 days?

  • Yes
  • No
  • Not sure
Q21
Multiple Choice

Do you have access to a computer with a webcam and microphone for an online session?

  • Yes
  • No
  • I can use a mobile device only
Q22
Multiple Choice

What is your current employment status?

  • Employed full-time
  • Employed part-time
  • Self-employed
  • Student
  • Not employed
  • Retired
  • Prefer not to say

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.

Frequently asked questions

What questions are in the “Stakeholder Interview Eligibility Screener” template?

The template includes 22 ready-to-use questions, starting with: “Welcome! This brief screener (approximately 10 minutes) helps us confirm your eligibility, recent experience, and availa…” · “Which option best describes your relationship with the organization conducting this study?” · “In the past 3 months, how often have you completed tasks or used tools related to [RESEARCH TOPIC]?”. The full set is previewed above, and every question is editable.

How long does this survey take to complete?

Respondents typically finish the 22 questions in about 10 minutes.

Can I customize this template?

Yes — every question, answer option, and the ordering is editable before you launch. You can add or remove questions, or ask the AI editor to rework the survey around your research goal.

Is this template free to use?

Yes. Open it in the editor and start customizing right away — no account required to try it, and the free plan covers launching your survey.

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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