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すべてのテンプレート
Nonprofit & Civic

Community Service Gaps & Priorities Assessment

A structured needs assessment for local governments and nonprofits to identify residents' service priorities, access barriers, and communication preferences to guide resource allocation.

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設問の例

テンプレートの内容をプレビューできます。すべての設問は公開前に自由に編集できます。

全23問・約10分
Q01
メッセージ

Welcome to the Community Service Needs Assessment. This survey asks about your experience with local services, the issues that matter most to you, and any barriers you have encountered. Your honest opinions will help inform local planning and resource decisions. • Participation is entirely voluntary. You may stop at any time. • There are no right or wrong answers — we want your genuine perspective. • Your responses are confidential and will only be reported in aggregate. • Estimated time: 8–10 minutes. Please read the consent question on the next screen to continue.

Q02
選択式

Which of the following community services have you personally used in the last 12 months? Select all that apply.

  • Healthcare/clinics
  • Mental health counseling
  • Public transit
  • Job training or employment services
  • Childcare/early learning
  • Housing assistance
  • Parks/recreation programs
  • Senior services
  • Library or public internet
  • Waste and recycling
  • Public safety services (non-emergency)
  • None of the above
  • Other
Q03
ランク付け

Please rank the following local issues by priority for the next 12 months. Drag to reorder (1 = highest priority).

  1. Affordable housing
  2. Public safety (non-emergency)
  3. Healthcare access
  4. Mental health and substance use support
  5. Jobs and skills training
  6. Childcare/early learning
  7. Public transit and mobility
ドラッグして順位を付ける
Q04
選択式

How would you prefer to hear about local services and events? Select all that apply.

  • Text/SMS
  • Email newsletters
  • Local social media groups
  • Posters/flyers in community spaces
  • Community organizations/faith groups
  • City or county website
  • Local newspaper/radio
  • Word of mouth
  • Other
Q05
AIインタビュー

We'd like to understand your experience with community services in more depth. Please share what has worked well or what could be improved, and our moderator will ask a few follow-up questions.

Q06
自由回答（長文）

What is your ZIP or postal code?

Q07
メッセージ

Thank you for completing the survey. Your responses are confidential and will help inform local planning and resource allocation. If you have questions about this study, please contact [organization name and contact information].

Q08
選択式

Do you voluntarily agree to participate in this survey?

  • I agree to participate
  • I do not agree
Q09
オピニオンスケール

Overall, how satisfied were you with the community services you used in the last 12 months?

スケール: 1 – 7
最小:Very dissatisfied最大:Very satisfied
Q10
オピニオンスケール

How urgently do you feel local services need to change over the next 12 months?

スケール: 1 – 7
最小:Not at all urgent最大:Extremely urgent
Q11
オピニオンスケール

In the last 12 months, how easy or difficult has it been to reach the right office or person when you needed help?

スケール: 1 – 7
最小:Very difficult最大:Very easy
Q12
自由回答（長文）

Based on your responses in this survey, is there anything else you would like to share about your community's needs or services?

Q13
自由回答（長文）

What is your neighborhood or nearest cross-streets? (optional)

Q14
選択式

Which best describes your connection to this community?

  • I live here
  • I don't live here, but I work or study here
  • I do not live, work, or study here
Q15
オピニオンスケール

Thinking about the last 12 months, how easy or difficult was it overall to access the community services you needed?

スケール: 1 – 7
最小:Very difficult最大:Very easy
Q16
プルダウン

About how long do you usually travel one-way to reach the community services you use most?

  • Less than 10 minutes
  • 10–19 minutes
  • 20–29 minutes
  • 30–44 minutes
  • 45–59 minutes
  • 60 minutes or more
  • I don't travel to services (online/phone only)
  • Not applicable
Q17
プルダウン

What is your age group?

  • Under 18
  • 18–24
  • 25–34
  • 35–44
  • 45–54
  • 55–64
  • 65 or older
  • Prefer not to say
Q18
選択式

Which barriers have you personally faced when trying to use community services in the last 12 months? Select all that apply.

  • Not aware of what's available
  • Hours don't fit my schedule
  • Transportation challenges
  • Cost or fees
  • Eligibility rules/documentation
  • Language barriers
  • Internet or device access
  • Childcare responsibilities
  • Physical accessibility
  • Concerns about privacy or stigma
  • Waitlists or delays
  • Staff responsiveness
  • Quality concerns
  • None of the above
  • Other
Q19
選択式

How do you describe your gender?

  • Woman
  • Man
  • Non-binary
  • Prefer to self-describe
  • Prefer not to say
Q20
プルダウン

What is the highest level of education you have completed?

  • Some high school or less
  • High school diploma or GED
  • Some college/associate degree
  • Bachelor's degree
  • Postgraduate or professional degree
  • Prefer not to say
Q21
選択式

What is your current employment situation? Select all that apply.

  • Employed full-time
  • Employed part-time
  • Self-employed
  • Unemployed and looking
  • Student
  • Retired
  • Homemaker/caregiver
  • Unable to work
  • Prefer not to say
Q22
プルダウン

Including yourself, how many people live in your household?

  • 1 (just me)
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7 or more
  • Prefer not to say
Q23
プルダウン

How long have you lived in this community?

  • Less than 6 months
  • 6–12 months
  • 1–3 years
  • 3–5 years
  • More than 5 years

含まれる機能

  • AIによる深掘り

    自由回答に合わせてAIが追加で質問し、固定のフォームでは拾えない具体的な内容を引き出します。

  • 注意確認設問

    急いだ回答や質の低い回答者を除外する仕組みを標準で備えています。

  • AIが作成する設問文

    文言、設問の順序、条件分岐をAIが調査の目的に合わせて作成します。

  • 自動レポート

    回答が集まると、テーマ、引用、わかりやすい要約が自動で作成されます。

他ツールとの比較

ほかのアンケートツールで最も近いテンプレートを調べました。それぞれの優れている点と、このテンプレートがさらに踏み込んでいる点をまとめています。

このテンプレートを選ぶ理由

  • Includes a dedicated AI follow-up interview question so residents can elaborate in their own words on service gaps, going beyond fixed-choice answers
  • Combines quantitative opinion-scale questions (satisfaction, access difficulty, urgency, reaching officials) with a ranking exercise so priorities are directly comparable across respondents
  • Captures access-barrier specifics (travel time, communication preferences, barriers faced) needed to guide equitable resource allocation, not just general satisfaction
  • Ends with an open-text reflection question plus demographic/location fields, giving local governments both narrative context and segmentable data for reporting

SurveySparrow

Sample Community Needs Assessment Survey Template

A printable, ready-to-use community needs assessment template covering typical service-use and satisfaction questions. It's built as a static question set rather than an adaptive interview, so all respondents see the same fixed items regardless of their answers. Useful as a quick-start form but not designed for deeper follow-up probing.

優れている点

  • Printable format supports paper or in-person distribution alongside online use
  • Pre-built question set saves setup time for a standard needs assessment
  • Backed by a broader survey platform with reporting/dashboard features

物足りない点

  • No adaptive AI follow-up questioning to probe deeper into open-ended answers
  • No automated per-response quality scoring of open text
  • No voice AI interview option for residents who prefer speaking over typing

Typeform

Online Community Needs Assessment Survey Template

A conversational, one-question-at-a-time survey template well suited to mobile completion and clean presentation. Logic can branch based on prior answers, but there is no AI-driven interviewing or automatic follow-up generation. Best suited to straightforward needs-assessment data collection rather than in-depth qualitative exploration.

優れている点

  • Polished, mobile-friendly conversational UI that can improve completion rates
  • Customizable branding and question flow
  • Conditional logic to route respondents based on answers

物足りない点

  • No adaptive AI interview or automated follow-up probing on open responses
  • No published methodology for how question logic or scoring works
  • No built-in per-response quality scoring or auto-generated qualitative reports

よくあるご質問

「Community Service Gaps & Priorities Assessment」テンプレートにはどのような設問が含まれていますか？

すぐに使える設問が23問含まれており、最初の設問は次のとおりです：「Welcome to the Community Service Needs Assessment. This survey asks about your experience with local services, the issu…」・「Which of the following community services have you personally used in the last 12 months? Select all that apply.」・「Please rank the following local issues by priority for the next 12 months. Drag to reorder (1 = highest priority).」。すべての設問は上でプレビューでき、自由に編集できます。

このアンケートの回答にはどのくらい時間がかかりますか？

回答者は通常、23問を約10分で回答し終えます。

テンプレートは編集できますか？

はい。公開前であれば、すべての設問、選択肢、順序を編集できます。設問の追加や削除のほか、調査の目的に合わせた作り直しをAIエディターに依頼することもできます。

このテンプレートは無料で使えますか？

はい。エディターで開けば、すぐに編集を始められます。お試しにアカウントは不要で、無料プランでアンケートを公開できます。

公開の準備はできましたか？

このテンプレートをエディターで開いてみてください。最初の回答者が目にする前に、すべてを自由に変更できます。

このテンプレートを使う無料で始める

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