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Retirement Readiness and Planning Confidence Survey

Measures how prepared people feel for retirement — perceived savings adequacy, understanding of plan mechanics, and where they turn (or don't turn) for advice. Built for financial services, benefits, and wealth-management teams. An AI follow-up probes the reasoning behind the respondent's confidence score, surfacing the specific knowledge gaps and unmet advice needs that generic satisfaction scores miss.

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Sample questions

A preview of what’s in the template. Every question is editable before you launch.

13 questions · ~7 min
Q01
Message

Thanks for taking a few minutes to reflect on your retirement planning. There are no right or wrong answers here — we're just trying to understand how prepared people feel and what would actually help. About 5 minutes.

Q02
Multiple ChoiceRequired

Which of the following retirement savings vehicles do you currently contribute to?

  • Employer-sponsored plan (e.g., 401(k), pension)
  • Individual retirement account (e.g., IRA, Roth IRA)
  • Taxable brokerage or investment account
  • Real estate or property investments
  • Business ownership or equity
Q03
Opinion ScaleRequired

How confident are you that your current savings and investments will be enough to maintain your desired lifestyle in retirement?

Scale: 1 – 7
Min:Not confident at allMax:Extremely confident
Q04
Number

At what age do you currently expect to retire?

Q05
MatrixRequired

How much do you agree with each of the following statements about your own retirement plan?

5 rows × 5 columns
  • I understand how my employer's retirement match or contribution works
  • I know roughly how much I need saved to retire comfortably
  • I understand the fees I'm paying in my retirement accounts
  • I know how to adjust my investment mix as I get closer to retirement
  • I have a written or documented plan for retirement income
Columns: Strongly disagree · Disagree · Neutral · Agree · Strongly agree
Q06
RankingRequired

Rank these retirement concerns from most to least worrying for you personally.

  1. Outliving my savings
  2. Healthcare or long-term care costs
  3. Market volatility affecting my nest egg
  4. Inflation eroding purchasing power
  5. Uncertainty about Social Security or public pensions
  6. Having to financially support family members
Drag to rank
Q07
Multiple ChoiceRequired

In the last 12 months, where have you gotten advice or information about your retirement plan?

  • A paid financial advisor or planner
  • My employer or HR/benefits team
  • Online tools or retirement calculators
  • Family or friends
  • Social media or online content creators
  • I haven't sought advice
Q08
Point AllocationRequired

If you had 100 points to divide across where you should be focusing your retirement planning effort right now, how would you split them?

  • Saving more each month
  • Choosing better investments/allocation
  • Planning for healthcare costs
  • Estate and legacy planning
  • Tax-efficient withdrawal planning
Allocate 100 points
Q09
AI Interview

Probe the gap between the respondent's stated confidence level and their actual plan knowledge from the matrix statements. If confidence is high but knowledge items were weak, dig into what's driving the false confidence (e.g., trust in an advisor they haven't talked to recently, not knowing what they don't know). If confidence is low, find out specifically which unknown — savings target, fees, income drawdown — is causing the most anxiety, and what kind of help (tool, advisor, employer resource) they'd actually use to resolve it.

Q10
Multiple Choice

Which age range do you fall into?

  • Under 30
  • 30–39
  • 40–49
  • 50–59
  • 60–69
  • 70 or older
  • Prefer not to say
Q11
Multiple Choice

What is your approximate annual household income?

  • Under $40,000
  • $40,000–$74,999
  • $75,000–$124,999
  • $125,000–$199,999
  • $200,000 or more
  • Prefer not to say
Q12
Multiple Choice

Which best describes your current employment status?

  • Employed full-time
  • Employed part-time
  • Self-employed
  • Unemployed / between jobs
  • Retired
  • Prefer not to say
Q13
Message

That's everything — thank you for your honesty. Your responses will be pooled into a report on retirement confidence and knowledge gaps, used to shape more useful planning resources and advice.

What’s included

  • AI follow-ups

    Adaptive probes on open-ended answers that pull out detail a static form would miss.

  • Attention checks

    Built-in safeguards against rushed answers and low-quality respondents.

  • AI-drafted copy

    Wording, ordering, and branching written by the AI — tuned to your research goal.

  • Auto report

    Themes, quotes, and a plain-English summary write themselves once responses come in.

How it compares

We reviewed the closest templates from other survey tools. Here’s what they do well — and where this template goes further.

Why this template

  • Goes beyond a single confidence rating: an AI follow-up interview step actively probes the gap between the respondent's stated confidence score and the specific knowledge gaps or unmet advice needs behind it, something a static question list can't surface.
  • Combines a matrix of agreement statements, a ranking of retirement concerns, and a point-allocation exercise (100 points across planning priorities) to triangulate where people actually feel shaky, not just whether they feel confident.
  • Captures where respondents did (or didn't) get advice in the last 12 months alongside plan-mechanics and savings-vehicle questions, giving benefits and wealth-management teams a fuller picture of advice-channel gaps.
  • Every AI follow-up prompt is transparent and reviewable, responses get automated per-response quality scoring, and results roll into an auto-generated report — available on a free tier or the $50/mo Business plan (no academic pricing tier).

Jotform

Retirement Planning Questionnaire Form Template

This is a static, fielding-ready form template built for collecting basic retirement-planning information, not an adaptive interview instrument. It's easy to deploy and customize within Jotform's form builder, but it asks fixed questions with no follow-up logic based on individual answers. Useful for quick data collection, less suited to uncovering the reasoning behind a respondent's confidence level.

What it does well

  • Quick to deploy using Jotform's drag-and-drop form builder
  • Fields are customizable to add or remove standard retirement-planning questions
  • Familiar, low-friction form format for respondents

Where it falls short

  • No adaptive AI follow-up — every respondent sees the same fixed question set regardless of their answers
  • No mechanism to probe the reasoning behind a confidence score or surface specific knowledge gaps
  • No automated per-response quality scoring or published prompt methodology, since there are no AI-driven questions at all

Ready to launch?

Open this template in the editor. Every part is yours to change before the first respondent sees it.

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