Contact Form
Take in inquiries in a structured way: the request, its urgency, contact details and the data protection consent — data-minimizing, with only a few required fields.
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.
Free to start
Publish the template on a free account — no credit card and no trial clock.
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
- What is your inquiry about?
- How can we help you?
- How urgent is your request?
- Are you already a customer of ours?
- What is your name?
- Which email address should we reply to?
- What is your phone number?
- Which company or organization are you writing on behalf of?
- How would you like us to get back to you?
- When is the best time to reach you by phone?
All 10 questions are fully editable.
Frequently asked questions
Is the “Contact Form” template free?
Yes. You can use, customize and publish the template for free — a free account is all you need.
How do I use the “Contact 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.
What data does the “Contact Form” template collect?
Which data you collect is decided question by question — if you don't ask for personal data, none is collected. Every question in the template can be changed or removed before you publish.
Are surveys built from the “Contact 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.