All Templates

Micro-Fulfillment Center Impact Survey Template

Collect resident feedback on traffic, noise, jobs, safety, and zoning around MFCs. Use this ready-to-send template to inform planning and policy decisions.

What's Included

AI-Powered Questions

Intelligent follow-up questions based on responses

Automated Analysis

Real-time sentiment and insight detection

Smart Distribution

Target the right audience automatically

Detailed Reports

Comprehensive insights and recommendations

Sample Survey Items

Q1
Multiple Choice
To the best of your knowledge, is there a micro-fulfillment center (MFC) within about 1 mile of your home?
  • Yes
  • No
  • Not sure
Q2
Dropdown
When did you first notice activity that seems related to an MFC near you?
  • In the last month
  • 1 to 3 months ago
  • 4 to 12 months ago
  • Over a year ago
  • I have not noticed any such activity
Q3
Numeric
About how far is the nearest place you consider an MFC from your home? (miles, approximate)
Accepts a numeric value
Whole numbers only
Q4
Multiple Choice
In the last 30 days, which of the following have you noticed in your area? Select all that apply.
  • More delivery vans on local streets
  • Nighttime truck arrivals
  • Curbside loading/unloading
  • Noticeable noise from vehicles or loading
  • Traffic congestion near intersections
  • Blocked sidewalks or bike lanes
  • None of the above
Q5
Multiple Choice
Attention check: To confirm you are paying attention, please select "I am paying attention."
  • I am paying attention
  • I am not paying attention
  • Prefer not to answer
Q6
Matrix
Compared with 3 months ago, how, if at all, have the following changed in your immediate area?
RowsMuch worseSlightly worseNo changeSlightly betterMuch betterDon't know/Not applicable
Traffic on residential streets
Parking availability
Noise during daytime
Noise at night
Pedestrian safety
Local air quality
Street cleanliness
Q7
Opinion Scale
Overall, how have MFC-related activities affected your quality of life in the last 3 months?
Range: 1 10
Min: Much worseMid: No changeMax: Much better
Q8
Rating
Based on what you know today, how much do you support having an MFC operating within 1 mile of your home?
Scale: 10 (star)
Min: Strongly opposeMax: Strongly support
Q9
Ranking
Rank the following city priorities related to MFCs (top = most important).
Drag to order (top = most important)
  1. Faster, reliable deliveries
  2. Fewer trucks on local streets
  3. Jobs and local hiring
  4. Lower noise levels
  5. Lower emissions/cleaner air
  6. Support for local retail
  7. Keeping prices affordable
Q10
Multiple Choice
Which measures would you support to reduce negative impacts from MFC operations? Select up to 3.
  • Time-of-day delivery windows
  • Electric-only delivery zones
  • Off-street loading requirements
  • Caps on van trips
  • Camera enforcement of loading zones
  • Safer bike/scooter lanes
  • Community hotline for issues
  • Regular city inspections
  • None of the above
Q11
Dropdown
How long have you lived in your current neighborhood?
  • Less than 6 months
  • 6–12 months
  • 1–3 years
  • 3–5 years
  • More than 5 years
Q12
Multiple Choice
What type of home do you live in?
  • Apartment/Condo
  • Townhouse/Rowhouse
  • Single-family house
  • Multi-family building (3+ units)
Q13
Multiple Choice
What is your housing situation?
  • Rent
  • Own
  • Other arrangement
  • Prefer not to say
Q14
Dropdown
What is your age?
  • Under 18
  • 18–24
  • 25–34
  • 35–44
  • 45–54
  • 55–64
  • 65 or older
  • Prefer not to say
Q15
Multiple Choice
What is your gender?
  • Woman
  • Man
  • Non-binary
  • Prefer not to say
Q16
Multiple Choice
What is your current employment status?
  • Employed full-time
  • Employed part-time
  • Self-employed
  • Unemployed and looking
  • Student
  • Homemaker/caregiver
  • Retired
  • Unable to work
  • Prefer not to say
Q17
Dropdown
What is the highest level of education you have completed?
  • Some high school or less
  • High school diploma or equivalent
  • Some college/Associate
  • Bachelor's degree
  • Graduate or professional degree
  • Prefer not to say
Q18
Short Text
What is your ZIP/postal code? (Optional)
Max 100 chars
Q19
Long Text
What else should the city know about MFC impacts on your block or nearby streets?
Max 600 chars
Q20
AI Interview
AI Interview: 2 Follow-up Questions on Micro-Fulfillment Centers
AI InterviewLength: 2Personality: Expert InterviewerMode: Fast
Q21
Chat Message
Thank you for participating—your input will help inform city decisions.

Ready to Get Started?

Launch your survey in minutes with this pre-built template