Testimonial Request Form
Collect customer testimonials with permissions for marketing use.
Free · No credit card required · 15 fields · Customize everything
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What's Included
15
Fields
1
Steps
2
Categories
0
Industries
Form Fields
This template includes 15 fields. Here's what respondents will see:
| Field | Type | Required |
|---|---|---|
| First Name | short answer | Yes |
| Last Name | short answer | Yes |
| Email Address | Yes | |
| Phone Number (optional) | phone | No |
| Company | short answer | No |
| Your Title / Role | short answer | No |
| Product or Service You Used | short answer | Yes |
| Overall Rating | rating | Yes |
| Your Testimonial | long answer | Yes |
| Specific Results or Outcomes (optional) | long answer | No |
| Upload Your Headshot (optional) | photo | No |
| How should we display your name? | radio | Yes |
| I give permission for my testimonial to be used on: | checkbox | Yes |
| I consent to my photo being used alongside the testimonial. | checkbox | No |
| I understand my testimonial may be lightly edited for length or clarity without changing the meaning. | checkbox | Yes |
Frequently Asked Questions
Do I need permission to publish a customer testimonial?
Yes. Always collect explicit written permission specifying where the testimonial may be published (website, email, social, ads). This form includes a required consent checkbox for legal compliance.
Can customers upload a headshot?
Yes. The form includes an optional photo upload field. The photo is only used if the customer explicitly consents via the photo consent checkbox.
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