--- generated_by: surveylegend-page-markdown title: Support Request Form Template | SurveyLegend description: Collect clear support requests with questions about the issue, impact, and steps already tried. Customize this support request form in SurveyLegend. canonical: https://www.surveylegend.com/survey-examples-templates/web-forms-questionnaires/support-request-form-template/ --- # Support Request Form Template This support request form template asks customers what they were trying to do, what happened instead, and how the issue affects them. Collect contact details and troubleshooting context so your team can prepare a useful first response to a nonemergency request. [Try this template ](https://app.surveylegend.com/register/)[Preview template](https://www.surveylegend.com/survey-examples-templates/web-forms-questionnaires/support-request-form-template/#try-template) Preview on a device Show the desktop survey preview Show the tablet survey preview Show the mobile survey preview ![Support Request Form: first question and response field, desktop preview](https://www.surveylegend.com/survey-template-media/previews/support-request-form-template-preview.avif) ![Support Request Form: first question and response field, tablet preview](https://www.surveylegend.com/survey-template-media/previews/support-request-form-template-preview-tablet.avif) ![Support Request Form: first question and response field, mobile preview](https://www.surveylegend.com/survey-template-media/previews/support-request-form-template-preview-mobile.avif) Support Request Form [Preview](https://www.surveylegend.com/survey-examples-templates/web-forms-questionnaires/support-request-form-template/#try-template) Share [Facebook ](https://www.facebook.com/sharer/sharer.php?u=https%3A%2F%2Fwww.surveylegend.com%2Fsurvey-examples-templates%2Fweb-forms-questionnaires%2Fsupport-request-form-template%2F)[LinkedIn ](https://www.linkedin.com/sharing/share-offsite/?url=https%3A%2F%2Fwww.surveylegend.com%2Fsurvey-examples-templates%2Fweb-forms-questionnaires%2Fsupport-request-form-template%2F)[X ](https://x.com/intent/tweet?url=https%3A%2F%2Fwww.surveylegend.com%2Fsurvey-examples-templates%2Fweb-forms-questionnaires%2Fsupport-request-form-template%2F\&text=Support%20Request%20Form%20Template)[Reddit](https://www.reddit.com/submit?url=https%3A%2F%2Fwww.surveylegend.com%2Fsurvey-examples-templates%2Fweb-forms-questionnaires%2Fsupport-request-form-template%2F\&title=Support%20Request%20Form%20Template) Use this support request form template to understand what a customer was trying to do, what happened, and how the problem affects them. The fields help your team ask fewer avoidable follow-up questions. Create your form in SurveyLegend and connect it to a support process your team can monitor. ## When to use this support request form Use the form as a clear entry point for ordinary service or product issues. State where responses go, when the channel is monitored, and how customers can reach your team through another route. Collect the issue before asking for unnecessary account information. This form does not itself create a ticket, guarantee a response time, or provide emergency assistance. After a case is handled, ask about the experience with our [technical support satisfaction](https://www.surveylegend.com/survey-examples-templates/technical-support-satisfaction-survey-template/) template. **Create your support request form in SurveyLegend** Use this support request form template to understand what a customer was trying to do, what happened, and how the problem affects them. The fields help your team ask fewer avoidable follow-up questions. ## 8 questions for your support request form Use these 8 questions as a starting point. All fields are optional; choose one answer where choices are listed. Leave an irrelevant open field blank. Respondent introduction:\ Describe the issue without including passwords, payment details, or other sensitive information. Provide an email address if you want a reply. This form is for ordinary support requests, not emergencies. All fields are optional. Try the survey ## A little feedback. A clearer picture. Explore this 8-question example at your own pace. Every question is optional. Preview on a device Show the survey at full desktop width Resize the survey to a tablet-width preview Resize the survey to a mobile preview with scrolling inside the frame Choose a look Use Classic: a white survey card over the background photo Use Light: dark text over a light tint covering the background photo Use Dark: light text over a dark tint covering the background photo SurveyLegend demo Question 1 of 8 ### Support Request Form 01 What name should we use when replying? Share your answer, or skip this question. 02 What email address should we use for this request? Share your answer, or skip this question. 03 Which product or service do you need help with? Share your answer, or skip this question. 04 What were you trying to do? Share your answer, or skip this question. 05 What happened instead? Share your answer, or skip this question. 06 How is this affecting you? Choose one answer, or skip this question. I cannot complete an essential task I can continue with a workaround It causes inconvenience but does not block my work I have a general question Something else 07 What have you already tried, if anything? Share your answer, or skip this question. 08 When did you first notice the issue? Share your answer, or skip this question. #### One last look Review your answers before submitting this demo. 0 answered #### Thank you for trying the survey! You’ve tried the template from the respondent’s side. Make it your own with SurveyLegend. [Create your own survey](https://www.surveylegend.com/register/) Checking submission availability… This is a demo. We count starts and submissions only. Your answers stay in your browser and are never sent or saved. **—**Starts **—**Submissions Activity is temporarily unavailable. ## How to customize your support request form Name the product or service and provide your real support contact details. Replace the broad impact choices with categories your team can triage consistently. Ask for a general description of the environment if it matters, but do not request passwords, full card numbers, access tokens, or private records. Keep attachments out unless you have reviewed that workflow. A short confirmation should explain the actual next step, without inventing a ticket number. Before sharing widely, try the questions with a few people from the intended audience and clarify anything they interpret differently. ## Printable support request form template Use this printable support request form template at a staffed service counter. It includes the same questions and space to write, giving people who prefer paper or are less comfortable online another way to take part. SurveyLegend helps you offer both formats. Tell respondents where to return the completed form and who will review it. Paper answers need a separate review or manual entry process; they are not automatically added to online responses. [![](https://www.surveylegend.com/user-guide-media/icons/download-pdf.svg) Download PDF](https://www.surveylegend.com/downloads/survey-templates/support-request-form-template.pdf) Export support request form template as PDF ## AI prompt for a support request form Help customers explain the problem so your team can make a useful first response. The full prompt below specifies your support request form, including all 8 questions and response settings. Copy it, register for a free SurveyLegend account, and paste it into SurveyLegend’s AI survey creation tool. Review the result and add your organization’s details before sharing. AI prompt for a support request form [Use prompt directly in SurveyLegend](https://www.surveylegend.com/register/) Create a free account, then paste the copied prompt into SurveyLegend. Already have an account? [Sign in to create your support request form.](https://app.surveylegend.com/login/) ## Use the request to choose the next support action Read the expected outcome beside what actually happened, then check the impact and attempted steps. Separate requests that block an essential task from general questions, using your own service priorities. Ask for missing details through the supplied contact route. Track resolution in your support system, not as a conclusion inferred from a form submission. After a resolved case, use a separate satisfaction survey to learn about the support experience. ## Frequently asked questions ### Does submitting the form create a support ticket? Only if you have configured and tested that workflow. This template defines the information to collect; it does not include an automatic ticketing connection. ### Should I ask for passwords or account access? No. Ask for a description of the issue and the contact details needed for a reply. 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[Start free](https://app.surveylegend.com/register/) to create your support request form and adapt the questions to your audience. [*Self-serve* Start free Create your first survey in minutes **Start free** ](https://app.surveylegend.com/register/)[*Guided help* Book a demo Talk with a SurveyLegend expert and choose the right plan. **Book a demo**](https://www.surveylegend.com/schedule-a-demo-of-surveylegend/)