survey from google Merchant

Hi, i want to integrate the surveyoptin fron Google Merchant, 

the example code is in the page https://support.goog...f_topic=7105160

I cretae a new topic on checkout_confirm_botton as HTML widget,

but i don't know how i pass de values that need google, like 

"order_id": "ORDER_ID",
"email": "CUSTOMER_EMAIL",
"delivery_country": "COUNTRY_CODE",
"estimated_delivery_date": "YYYY-MM-DD",

Thanks for help!