RESEARCH

Experience diary check-in survey template

Capture a short account of a recent experience across repeated study waves.

7 questions · 1 pages · 4 answer formats · About 2 min

Time is estimated from all questions, including matrix rows. Branching can shorten a path; reading, consent and longer written answers can add time. Confirm it with a pilot.

Conditional questions
Pro to publish

Use this template →Try the survey Read every question

Free to preview and customize. Publishing this template with its configured advanced features requires Pro.

Use this template opens an editable draft after sign-in. Questions, answer options and configured logic carry over; nothing is published until you choose to publish.

Try the questionnaire

Answer it before you use it.

Try the actual questions, follow-ups and endings. Preview answers stay in this tab and disappear when you close or restart it. Nothing is submitted.

Who this is for

Researchers studying repeated use and changing experiences.

Before you send it

Create one survey per wave in a study, reuse a pseudonymous participant ID, and arrange the invitation schedule externally. Do not ask people to recreate distant experiences.

Questionnaire preview

These are the questions and answer options copied into your draft. Bracketed text is a prompt to customize. Matrix questions contain several statements, so allow time for each row.

Page 1

1. When did the experience happen? (required)
Date
2. Did you use the product or service during this period? (required)
Choose one
YesNo
3. What were you trying to do?
Long text
4. How did that experience go?
1–7 scale (Very poorly → Very well)
5. What helped or got in the way?
Long text
6. Why did you not use it this time?
Long text
7. Is there anything you want to try differently next time?
Long text

Use this template →

Use the builder link to retain logic, piping, consent, scoring, and randomization. Plain text copies wording only; piped answers become editable placeholders.

How to read the results

Use linked exports to examine within-person change and missed waves. A missed check-in is not evidence that no experience occurred. Compare event dates with submission dates.

Preview your edited survey on desktop and mobile, run a small pilot, and review an export before inviting the full audience. Adding questions is optional: keep the ones that support your decision.