Screener Survey Template
A free screener survey template for market researchers and UX teams. Find the right people for focus groups and interviews before you invite them.
Customize the pages and design to fit your needs.
About this template
Screen participants on age, work, recent behavior, industry conflicts, past studies and availability, with an open question that shows who can explain their thinking. Use conditional logic to end early for people who don't qualify.
Common uses
- Focus group recruiting
- User interviews and usability tests
- Market research panels
Key features
- Industry and past study checks
- Open answer quality check
- Conditional logic to screen out
What this template asks
What's your name?
Short Text
What's your email address?
Email
What's your phone number?
Phone · Optional
What's your age?
Single Choice · Under 18, 18 to 24, 25 to 34, 35 to 44, 45 to 54, 55 or older
Which best describes your work?
Single Choice · Business owner, Manager, Individual contributor, Student, Not working right now
Which of these have you done in the past 3 months?
Multiple Choice · Bought something online, Used a meal kit, Booked a trip, Switched phone plans, None of these
Do you or anyone in your household work in market research, advertising or journalism?
Yes / No
When did you last take part in a paid study?
Single Choice · In the past 3 months, 3 to 12 months ago, Over a year ago, Never
In a sentence or two, describe a product you love and why.
Long Text
Which formats can you join?
Multiple Choice · Online video call, In person, Online survey only
When are you usually free?
Multiple Choice · Weekday mornings, Weekday afternoons, Weekday evenings, Weekends
How to use this template
Copy it
Select Use template and a copy opens in your workspace as an unpublished draft.
Make it yours
Edit any question or answer, choose a theme, and add your logo.
Share it
Publish, then send the link, show a QR code, or embed the form on your site. Responses arrive in Submissions.
Frequently asked questions
What is a screener survey?
A short survey you send before a focus group, interview or study to check that each person fits the profile you need, and to screen out people who don't.
What should a screener survey include?
Demographics, recent behavior, a question about working in research or advertising, past study participation, an open answer to check they can explain their thinking, and availability.
Can I end the screener early for people who don't qualify?
Yes. Use conditional logic to send people who don't match to a polite ending, so only qualified people see the rest of the questions.