NPS Survey Template

<!-- Link to this page as e.g. /nps?cid=C-2291 so the customer ID is captured -->
<form action="https://splitforms.com/api/submit" method="POST">
  <input type="hidden" name="access_key" value="YOUR_ACCESS_KEY">
  <input type="hidden" name="subject" value="New NPS response">
  <input type="hidden" name="survey" value="NPS 2027-Q1">
  <input type="hidden" name="customer_id" id="customer_id">
  <input type="hidden" name="form_loaded_at" id="form_loaded_at">

  <fieldset>
    <legend>How likely are you to recommend [Company] to a friend or colleague?</legend>
    <p id="nps-scale-help">0 = Not at all likely, 10 = Extremely likely</p>
    <div role="radiogroup" aria-describedby="nps-scale-help">
      <label><input type="radio" name="score" value="0" required> 0</label>
      <label><input type="radio" name="score" value="1"> 1</label>
      <label><input type="radio" name="score" value="2"> 2</label>
      <label><input type="radio" name="score" value="3"> 3</label>
      <label><input type="radio" name="score" value="4"> 4</label>
      <label><input type="radio" name="score" value="5"> 5</label>
      <label><input type="radio" name="score" value="6"> 6</label>
      <label><input type="radio" name="score" value="7"> 7</label>
      <label><input type="radio" name="score" value="8"> 8</label>
      <label><input type="radio" name="score" value="9"> 9</label>
      <label><input type="radio" name="score" value="10"> 10</label>
    </div>
  </fieldset>

  <label>What is the main reason for your score?
    <textarea name="reason" rows="4"></textarea>
  </label>

  <label>Email, if you're happy for us to reply (optional)
    <input type="email" name="email" autocomplete="email">
  </label>

  <!-- honeypot: leave empty -->
  <input type="checkbox" name="botcheck" style="display:none" tabindex="-1" autocomplete="off">

  <button type="submit">Send my score</button>
</form>
<script>
  document.getElementById('form_loaded_at').value = Date.now();
  document.getElementById('customer_id').value =
    new URLSearchParams(location.search).get('cid') || '';
</script>