University Surveys

Survey Request Form Instructions

The following provides detailed instructions for how to fill out the survey request form. See the University Surveys Overview for instructions on how to submit a survey request.


Contact Information

Please fill out all of the information for the primary contact. If you would like to include more than one contact please send his or her information in the same e-mail as the survey request form.

If the survey is a student project please check the "Student project" box and include the faculty adviser's contact information in the Additional Notes section on page two of the form.  Examples of student projects include graduate student thesis research and undergraduate student research.  The faculty supervisor will need to send confirmation that he or she is overseeing the project.

IRB Status

It is the responsibility of the person requesting the survey to communicate with the WIU Institutional Research Board (IRB) Compliance Officer about whether their survey requires IRB approval. IRB approval is usually needed when the purpose of the survey is to conduct research using human subjects, the results of which may be published in a journal or presented at a conference. Examples of surveys that typically do not require IRB review are those used for personnel or program review and class projects. Visit the Office for Sponsored Project's Compliance page for more information. You can contact the IRB compliance officer at for help in determining whether your survey requires IRB review.

On the survey request form:

  • If you have determined the survey does not require IRB approval check "IRB review not required."
  • If you have not yet submitted a protocol to the IRB or your protocol is currently being reviewed check "Pending."
  • If your research protocol has been approved check "Approved" and provide the protocol or approval number.

Copyright / Intellectual Property Status

If your survey does not contain any portion of a questionnaire that has been copyrighted or is the intellectual property of another party check “Not applicable.”

If you are using all or part of a published questionnaire in your survey you may need to obtain approval before the survey is deployed. If you know that the questionnaire does not require approval check “Exempt / Public domain.” If you have obtained approval check “Approved.” You will also need to submit documentation showing that use of the questionnaire has been approved.

You can contact CITR if you need help with determining the copyright / intellectual property status of your survey.


Activation date: Indicate the date you would like your survey to be activated. In the case of anonymous surveys this would be the date the survey link becomes valid. For invited surveys this is typically the date that the first e-mail invitation should be sent. In general you should allow 2-3 weeks between the time the survey request is submitted and the activation date.

Closing date: Indicate the date you would like the survey to become inactive. Once inactive the survey’s links will no longer work.

Remove identifying information during data collection.  Check this if you would like all identifying information removed from the data.  IP address and location information normally collected for both anonymous and invited (e-mailed) surveys will be removed.  For invited surveys all identifying information provided with the e-mail list will also be removed.  

Anonymous or Invited (Qualtrics e-mailer): Please select one of these two options. See the survey request steps for more information about these distribution methods.

For Anonymous distribution:

  • CITR will provide you with a hyperlink for the anonymous survey. If the link will be distributed using Tele-STARS check “Tele-STARS” distribution.” If you will be distributing the link check “Survey link only.”
  • CITR does not submit requests for Tele-STARS e-mail distribution.  You will be provided with an anonymous link to the survey which should be added to the e-mail text on the Tele-STARS request form.

For Invited distribution (Qualtrics e-mailer):

  • Describe the group that will participate in the survey.  This can be a very short description, for example “WIU undergraduates” or “Macomb residents.”
  • E-mail list available: Check this if you have the list of recipients at the time you are submitting the request.  If the list is available it should be submitted along with the survey request form. 
  • Invitation e-mail fields: Please fill out all of these. Keep in mind that if participants have questions about the survey they may reply to the invitation, so you may want a “reply-to” address that is actively monitored.
  • E-mail dates: Indicate the date and time that the invitation and optional reminder e-mails should be sent.
    • Both of these will have links to the survey, and the reminders will only be sent to those who have not completed the survey.
  • Make sure you submit the text portion of the initial and reminder e-mails in a separate file or e-mail.

Additional Notes / Instructions

Include any additional notes or instructions here.  If there is not enough space you can send notes in a separate file.

Files Included with the Request

Please check which files are being submitted along with the survey request form and provide the file name.

  • The survey should always be included.
  • IRB and copyright approval documentation can be sent as a file or submitted as a separate e-mail (e.g. approval e-mail forwarded from the IRB).
  • For invited / Qualtrics e-mailer surveys:
    • Include the invitation and reminder e-mail text. These can be in a text file or Word document.
    • Include the e-mail list if available. The list should be in an Excel, CSV, or text file. E-mail addresses should be in a single column. You can include additional information in separate columns when using Excel or CSV files (e.g. first and last names for customized invitation and reminder e-mails).

If you have graphics files, data for drill down questions, or other miscellaneous files, include a separate Word or text document with a name and description of each file.