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Anonymous Submission Form

Easily submit anonymous feedback or information with our secure Anonymous Submission Form. Keep your identity protected while sharing valuable insights. Streamline the process of providing feedback without the need for personal information.

2 minutes to complete

Eligibility

This form should be filled out by those individuals who agree to participate in the survey anonymously.

Questions for Anonymous Submission Form

Questions

1.

What type of submission are you making?

The answer should be a single choice:
  1. Feedback
  2. Suggestion
  3. Concern/Issue
2.

Please provide a brief description of your submission:

The answer should be a text input.
3.

How urgent is this submission?

The answer should be a single choice:
  1. Very urgent
  2. Urgent
  3. Not urgent
4.

How satisfied are you with the current situation related to your submission?

The answer should be a single choice:
  1. Very satisfied
  2. Satisfied
  3. Neutral
  4. Dissatisfied
  5. Very dissatisfied
5.

What improvements or changes would you suggest?

The answer should be a text input.
6.

Have you previously submitted feedback or concerns regarding this issue?

The answer should be a single choice:
  1. Yes
  2. No
7.

Would you like to be contacted for follow-up regarding this submission? 

The answer should be a single choice:
  1. No
8.

Any additional comments or information you would like to share?

The answer should be a text input.

Forms Similar to Anonymous Submission Form

  • Confidential Feedback Form
  • Unidentified Response Form
  • Discreet Survey Form
  • Incognito Inquiry Form
  • Silent Participation Form
  • Private Input Form

Here are some FAQs and additional information
on
Anonymous Submission Form

Is my submission completely anonymous?

Yes, your identity or personal details will not be collected or stored.

Can my submission be traced back to me?

No, we have no way of identifying individuals who submit through this form.

How will my anonymous feedback be used?

Your feedback will be reviewed confidentially to help improve our services or processes.

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About Us

BlockSurvey is a privacy-focused platform for collecting data through forms, surveys, assessments, and quizzes. The data collection is end-to-end encrypted, and it ensures complete privacy of your audience from Big Tech. With an array of ready to use templates, it is tailored for the needs of businesses and individuals from Web 3, HR, Mental Health, Sexual Health, Activism and many sensitive areas where data collection needs protection.

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