---
title: Example: Create a satisfaction survey form
slug: cms-12/docs/example-create-a-satisfaction-survey-form
docTags: 
createdAt: 2026-08-10T15:55:59.000Z
---

The following example shows how to create a survey with satisfaction questions in multiple steps. The visitor selects answers from predefined choices. The form also contains mandatory fields and displays a progress bar to let the visitor know how many questions remain. It uses form elements: [Form step](docId\:dGqSQKV0mgM33Efyrw9v5), [Multiple or single choice](docId\:dGqSQKV0mgM33Efyrw9v5), [Text](docId\:dGqSQKV0mgM33Efyrw9v5), [Text area](docId\:dGqSQKV0mgM33Efyrw9v5), [Hidden visitor profiling](docId\:dGqSQKV0mgM33Efyrw9v5), [Hidden predefined value](docId\:dGqSQKV0mgM33Efyrw9v5), and [Submit button](docId\:dGqSQKV0mgM33Efyrw9v5).

1. From the assets panel, select **Forms** to list the existing form folders.
2. From a folder's context menu, select **New Form** and give it a name such as *Satisfaction Survey*.
3. Edit the form container settings in the **All properties** view as follows:

   - **Form title** – Give the form the title *Satisfaction Survey*.
   - **Description** – Enter the description *Take our survey!*
   - **Confirmation message** – Enter the confirmation message *Thank you for taking our survey.*
   - **Show navigation bar...** – Select the **Show navigation bar...** check box.

   ![Satisfaction survey metadata](https://api.archbee.com/api/optimize/BrbvVORKJ5iIeSMZye5kI/aZB4DUcWiiP1oqSZ58omH-20260720-145558.png "Satisfaction survey metadata")
4. Drag the following form elements onto the **Form elements** section in the new form container. Change the elements as follows (add your own **Placeholder** text) and publish each element:
   - [Form step](docId\:dGqSQKV0mgM33Efyrw9v5) – Label the form element *Step 1*.
   - [Multiple or single choice](docId\:dGqSQKV0mgM33Efyrw9v5) – Adjust the settings of the form element as follows:
     - **Name the element**: *Service satisfaction*
     - **Label text**: *How would you rate our service?*
     - **Tooltip**: *Choose from 1 (poor) to 5 (excellent)*
     - Select the **Required** check box.
     - Under **Choices**, select **Use manual input** and add the following items:
       - **Choice**: *5 Excellent*; **Value** *5*.
       - **Choice**: *4 Great*; **Value** *4*.
       - **Choice**: *3 Neutral*; **Value** *3*.
       - **Choice**: *2 Lacking*; **Value** *2*.
       - **Choice**: *1 Poor*; **Value** *1*.
   - [Form step](docId\:dGqSQKV0mgM33Efyrw9v5) – Label the form element *Step 2*.
   - [Multiple or single choice](docId\:dGqSQKV0mgM33Efyrw9v5) – Adjust the settings of the form element as follows:
     - **Name the element**: *Returning customer*
     - **Label text**: *How likely are you to return?*
     - **Tooltip**: *How likely are you to return?*
     - Select the **Required** check box.
     - Under **Choices**, select **Use manual input** and add the following items:
       - **Choice**: *5 I'll be back!*; **Value** *5*.
       - **Choice**: *4 It is likely.*; **Value** *4*.
       - **Choice**: *3 Maybe yes.Maybe no.*; **Value** *3*.
       - **Choice**: *2 I don't think so.*; **Value** *2*.
       - **Choice**: *1 No way!*; **Value** *1*.
   - [Form step](docId\:dGqSQKV0mgM33Efyrw9v5) – Label the form element *Step 3*.
   - [Text](docId\:dGqSQKV0mgM33Efyrw9v5) – Label the form element *Email address (optional)* and add a tooltip.
   - [Text area](docId\:dGqSQKV0mgM33Efyrw9v5) – Label the form element *Comments* and add a tooltip.
   - [Hidden visitor profiling](docId\:dGqSQKV0mgM33Efyrw9v5) – Select **Visitor Groups** > **Name**. This field is used for internal purposes only and is not displayed to the visitor. Optimizely will log the visitor group each visitor (who fills in the form) belongs to.
   - [Hidden predefined value](docId\:dGqSQKV0mgM33Efyrw9v5) – Enter *Satisfaction-survey* in **Predefined value**. This field is used for internal purposes only and is not displayed to the visitor. You can use the predefined value to associate the form with a specific campaign or survey and so on.
   - [Submit button](docId\:dGqSQKV0mgM33Efyrw9v5) – Label the button *Submit Survey* and add a tooltip.
5. Publish the form container. It displays in your Forms list.

   ![Forms gadget](https://api.archbee.com/api/optimize/BrbvVORKJ5iIeSMZye5kI/YTu8yeJqz-RFutVEybQ9H-20260720-145558.png "Forms gadget")
6. Drag the *Satisfaction Survey* form onto a web page and publish the page.

## Test your form

To test your form, go to the page on the website and enter data into the form on the page in View mode.

1. Select an option and click **Next Step**.

   ![Step 1 example](https://api.archbee.com/api/optimize/BrbvVORKJ5iIeSMZye5kI/9ZVwjuLfJIc49HGQwYWFe-20260720-145558.png "Step 1 example")
2. Select an option and click **Next Step**.

   ![Step 2 example](https://api.archbee.com/api/optimize/BrbvVORKJ5iIeSMZye5kI/S8ZtFXvNOzBIbEC0gU17U-20260720-145558.png "Step 2 example")
3. Enter an email address and comments and click **Submit Survey**. A confirmation box displays. When you submit the data, it is stored in Optimizely.

   ![Step 3 example](https://api.archbee.com/api/optimize/BrbvVORKJ5iIeSMZye5kI/9hcRXL76ZH9P0tRJV043Z-20260720-145558.png "Step 3 example")

   ![Example of confirmation box](https://api.archbee.com/api/optimize/BrbvVORKJ5iIeSMZye5kI/bHMS-7xMCgDhYFjD5NRi0-20260720-145558.png "Example of confirmation box")

   :::hint{type="info"}
   **Note**

   This Summary dialog box is styled this way because the [Optimizely Forms Samples](docId\:dGqSQKV0mgM33Efyrw9v5) package was installed. If you use a default Optimizely Forms installation without the Samples package, this dialog box has a simpler, uncolored look.)
   :::

## View form submissions

To view your test results, go to your *Satisfaction Survey* form in the Forms gadget and select **Form submissions** from the context menu. The **Form submissions** view displays data submitted from the form.

![Survey form submissions](https://api.archbee.com/api/optimize/BrbvVORKJ5iIeSMZye5kI/ntO7Gj9SUw9CjG8tY1oSZ-20260720-145558.png "Survey form submissions")