Professional services · Satisfaction survey

Insurance Agency Policyholder Satisfaction Survey Template

Measure how policyholders and prospects feel about their insurance service interaction and identify the changes that would matter most. Every block is editable, and the finished form uses ResponseMint's focused respondent experience.

7 pages7 answer fields3 min typical completionFree to customize
No card required. Every block stays editable.

The form itself

Blocks included

These are the exact starting questions and content blocks that will appear in your ResponseMint workspace.

  1. 01
    Dropdown

    Which service or experience are you rating?

    • Auto insurance
    • Home insurance
    • Life insurance
    • Business insurance
    Required
  2. 02
    Rating

    How satisfied were you with your overall insurance service interaction?

    Required
  3. 03
    Opinion scale

    How likely are you to recommend this insurance agency?

    Required
  4. 04
    Multiple choice

    Which part had the biggest effect on your rating?

    • Coverage clarity
    • Responsiveness
    • Claim support
    • Value
    Required
  5. 05
    Long answer

    What worked especially well?

  6. 06
    Long answer

    What is the one thing we should improve?

  7. 07
    Yes or no

    May the insurance agency contact you about your response?

Make it yours

Start close. Edit freely. Publish confidently.