Order Form
Take orders without a shop system: items and quantities, delivery and billing address, preferred date, payment method and a binding confirmation.
Take the template with one click, adapt it to your project in a few minutes and start collecting answers.
Why this template
Adapted in minutes
Change, add or remove questions — the AI assistant rephrases them on request.
Hosted in the EU
Survey data is processed and stored in the EU — taking part anonymously is possible.
Results in real time
Charts, filters and export to Excel, SPSS or CSV — with no extra work.
How to use this survey
- 1
Take the template
Create a free account and copy the template into your project with one click.
- 2
Adapt the questions
Adjust wording, scales and logic to your context — as often as you like.
- 3
Invite respondents
Share it by link, QR code, email or embedded on your website.
- 4
Analyse the answers
A live dashboard with charts, filters and export into your analysis tool.
The questions in this template
- Are you ordering as a private individual or for an organisation?
- Which items would you like to order?
- What is your first name and surname?
- Which organisation should the invoice be made out to?
- What is your customer number, if you have ordered from us before?
- Which email address should we send the order confirmation to?
- What phone number can we reach you on if there are questions about the delivery?
- How would you like to receive your order?
- Which address should we deliver to?
- Is the billing address different from the delivery address?
- What is the billing address?
- When would you like the delivery to arrive?
All 14 questions are fully editable.
Frequently asked questions
Is the “Order Form” template free?
Yes. You can use, customise and publish the template for free — a free account is all you need.
How do I use the “Order Form” template?
One click on “Use this template” creates it as your own survey in the editor. From there you can adapt it and share it by link, QR code, email or embedded on your own website.
Can I change, delete and add questions?
Completely. Once taken, the survey sits in your editor: every question, scale and answer option can be edited, reordered or removed.
Where is the data from the “Order Form” template stored?
Survey data is processed and stored in the EU. Which data you collect is decided question by question — if you don't ask for personal data, none is collected.
Are surveys built from the “Order Form” template secure and anonymous on empirio.ai?
Respondents need no account and simply open the link. Whether answers stay anonymous is up to the questions you ask: as long as nothing personal is asked, no answer can be traced back to a person.