Survey Questionnaire Designer

Example output

Survey questionnaire — Willowmere herbal tea usage & attitudes (target: under 12 minutes)

Screener
S1. Which of the following have you personally purchased in the past 3 months? [Herbal or wellness tea / Black or green tea / Coffee / None of these] — qualify respondents who select herbal or wellness tea.
S2. How often do you purchase herbal or wellness tea? [Multiple times a week / About once a week / 2-3 times a month / Once a month / Less often] — qualify 2-3 times a month or more often.
S3. Age band — quota to your target distribution.
S4. Do you or anyone in your household work in market research, advertising, or the food and beverage industry? [Yes / No] — terminate if yes.

Core questions

Category behavior
Q1. Which herbal or wellness tea brands have you purchased in the past 3 months? [Multi-select brand list + Willowmere + Other]
Q2. Thinking about your last purchase of Willowmere, what occasion was it for? [Wind-down before bed / Mid-day break / Feeling under the weather / Digestive discomfort / Just enjoy the taste / Other]
Q3. How many cups of herbal tea do you drink in a typical week? [Open numeric]

Attitudes toward the category (5-point agree/disagree, randomized order)
Q4. "I buy herbal tea because I want a specific benefit, not just a beverage."
Q5. "I would pay more for a tea brand that clearly targets one specific need, like sleep or digestion."
Q6. "Most herbal tea flavors on the market taste similar to me."

Brand-specific ratings (5-point scale)
Q7. Rate your overall satisfaction with Willowmere.
Q8. Rate Willowmere on: taste, packaging, price, availability where you shop, variety of flavors. [grid]

Functional sub-line reaction (shown only to Willowmere buyers who qualify past S2)
Q9. If Willowmere launched teas formulated for specific needs — Sleep, Calm, and Digestion — how likely would you be to try at least one? [5-point purchase-intent scale; Top-2-box is the headline metric]
Q10. Which of the three needs would you be most interested in? [Sleep / Calm / Digestion / None of these]
Q11. Open-end: "What, if anything, would make you hesitant to try a functional Willowmere tea?"

Closing
Q12. Household income band [standard ranges]
Q13. Any final thoughts on Willowmere or herbal tea in general? [Open-end, optional]

Field-readiness checklist
- Estimated length: 10-12 minutes at 13 questions plus screener — on target.
- Randomize Q4-Q6 and the brand list in Q1 to avoid order bias.
- Set the action standard before fielding: proceed with functional sub-line scoping if Q9 Top-2-box intent clears your category's historical concept-test norm (insert your norm) and Q10 shows a clear lead need rather than a three-way split.
- Confirm Qualtrics logic: S1-S4 must terminate or route correctly before Q1 loads.
- Sample size isn't set here — confirm with your research team based on the confidence interval you need for the Q9/Q10 read.

Note: Q9's "likely to try" measure is a stated-intent proxy for an undeveloped concept, not a screened concept test — treat the functional-line read as directional interest that justifies further concept development, not a launch decision on its own.

Want a shorter 5-minute version for an intercept or app-based sample, or this 13-question version formatted for a different survey tool?