Phase 1 Research Survey
A first-phase research survey to understand participant background, goals, ratings, and follow-up preferences. The form should feel clean, premium, and easy to complete.
Participant Profile
Name
*
Email address
*
example@example.com
Role / job title
*
Organization / company name
*
Research Context
Primary research topic or problem area
*
Main goal or objective of participation
*
Current experience level related to this topic
*
Beginner
Intermediate
Advanced
Expert
Survey Ratings and Input Table
Interest in the research topic
*
Not at all interested
1
2
3
4
Extremely interested
5
1 is Not at all interested, 5 is Extremely interested
Rate the focus areas
*
Rows
1
2
3
4
5
Clarity
1
2
3
4
5
Urgency
6
7
8
9
10
Relevance
11
12
13
14
15
Expected impact
16
17
18
19
20
Follow-up Preferences
Preferred contact method
*
Email
Phone
Text message
No follow-up
Additional notes, constraints, or questions
Submit Survey
Should be Empty: