Online reputation management questionnaire template
This six-step online reputation management questionnaire asks how the business rates its reputation, its goal, past services, urgency and any notes, followed by the contact details. Clone it into your Growform account and add your review platforms.
What the form asks, step by step
Reputation clients arrive with very different problems, from a single bad review to negative press. The form sorts them by severity and urgency before the first call.
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Step 1: “How would you rate your online reputation?”
A self-rating from excellent to poor shows how much repair work is needed.
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Step 2: “What is the main reason for improving your online reputation?”
Sales, brand image, new customers or negative press defines the strategy.
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Step 3: “Have you ever used reputation management services?”
Previous clients know the process, while first-time buyers need more explanation.
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Step 4: “How urgent is your need for reputation management?”
Very urgent cases often involve a live crisis and need a same-day reply.
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Step 5: More information
Prospects can mention the platforms, reviews or articles that concern them.
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Step 6: “How shall we contact you?”
Name, email and phone come last.
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After submitting
When a business submits, it sees a stock message, which an agency would rewrite to promise a confidential reply.
Who it’s for
Online reputation management agencies, review management platforms and PR firms use this reputation management questionnaire to qualify new clients. It separates businesses that want more positive reviews from those responding to a crisis, and it shows how quickly they need help. The notes step collects the details that are awkward to say on a first call. Agencies that also offer media work can compare the public relations template.
Why this structure converts
- The self-rating question lets a business admit a problem without describing it in detail.
- “Recover from negative press” is an option, which reassures businesses in a crisis that you handle their situation.
- Urgency is asked directly, so crisis cases can be answered first.
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Make it yours
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Ask for review platforms
Add a multi-select step for Google, Yelp, Trustpilot and social media so you know where the problem is.
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Respond quickly to crises
Use conditional logic to show a direct phone number to anyone who selects “Very urgent”.
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Keep it confidential
Rewrite the thank-you screen to say how you handle sensitive information, which matters to businesses under pressure.
Frequently asked questions
What should a reputation management questionnaire ask?
It should ask how the business sees its reputation, the goal, any past work and the urgency. Platform and review details can follow in the audit.
Can I prioritize urgent cases?
Yes. Send “Very urgent” answers to a Slack alert or a separate email so the team replies first.
Where do the questionnaires go?
Responses go to your email and can be sent to HubSpot, Pipedrive, ActiveCampaign or a Google Sheet.
What happens next?
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Step 1: Clone this form template
Clone this template into your Growform account (create one first if you don’t already have one). -
Step 2: Edit your form
Get creative and adjust your form's theme options, questions or layout in the Growform form builder. -
Step 3: Share or embed your form
Share a link to your form, or embed it in your existing website. Receive new submissions by email or send them to 7,000+ apps via Zapier.
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