Q01
Message
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School Safety & Violence Climate Survey
Measures how safe students feel at school, how often they witness or experience bullying and violence, and how much they trust adults to respond — with an AI follow-up interview that reconstructs a specific safety incident and probes what would make a student more likely to report one. Built for middle and high school safety climate assessments.
Sample questions
A preview of what’s in the template. Every question is editable before you launch.
14 questions · ~7 min
Q02
Opinion ScaleRequired
How safe do you feel while at school during a typical school day?
Scale: 1 – 5
Min:Not safe at allMax:Extremely safe
Q03
Multiple ChoiceRequired
In the last 30 days, how many times have you seen a physical fight or physical violence happen at school?
- Never
- Once
- 2-3 times
- 4 or more times
Q04
Multiple ChoiceRequired
In the last 30 days, how often have you personally been bullied at school, in person or online?
- Never
- Once or twice
- About once a week
- Several times a week or more
Q05
MatrixRequired
How safe do you feel in each of the following places at school?
7 rows × 4 columns
- Classrooms
- Hallways between classes
- Cafeteria during lunch
- Restrooms
- Locker rooms
- +2 more
Columns: Very safe · Somewhat safe · Somewhat unsafe · Very unsafe
Q06
Multiple ChoiceRequired
Which of the following have you personally seen or heard about happening at your school this school year? Select all that apply.
- Physical fights between students
- Verbal threats of violence
- A weapon reported on campus
- Bullying or cyberbullying
- Vandalism or graffiti related to threats
- Gang-related activity
Q07
Opinion ScaleRequired
How confident are you that adults at your school would respond effectively if you reported a safety concern?
Scale: 1 – 5
Min:Not at all confidentMax:Extremely confident
Q08
Opinion ScaleRequired
If you witnessed a safety incident at school, how likely would you be to report it to a teacher or staff member?
Scale: 1 – 5
Min:Very unlikelyMax:Very likely
Q09
Best–Worst Trade-off (MaxDiff)Required
Which of these changes do you think would do the most — and the least — to improve safety at your school?
- More adult supervision in hallways and common areas
- An anonymous reporting system for safety concerns
- Conflict resolution or peer mediation programs
- Metal detectors or security screening at entrances
- More counselors or mental health support staff
- Clearer and more consistent discipline for rule violations
- Safety and de-escalation training for students
- Better lighting and security cameras on campus
Pick best & worst per setBest:Would improve safety the mostWorst:Would improve safety the least
Q10
AI Interview
Probe the respondent's most recent or most vivid experience of feeling unsafe or witnessing a safety incident at school: what happened, where, who was involved, and whether it was reported. If they gave low confidence in how adults respond or said they'd be unlikely to report an incident, dig into the specific reason — fear of retaliation, belief nothing would change, not knowing how to report — and what would make them more willing to speak up. Keep the tone neutral and non-judgmental, and do not ask for identifying details about other students.
Q11
Long Text
Is there anything else about safety at your school you'd like adults to know?
Q12
Dropdown
What grade are you in?
- 6th
- 7th
- 8th
- 9th
- 10th
- 11th
- 12th
- Prefer not to say
Q13
Multiple Choice
What is your gender?
- Female
- Male
- Non-binary
- Prefer to self-describe
- Prefer not to say
Q14
Message
Thank you for sharing your experience. Your responses will be combined with others' to help school leaders see where students feel unsafe and improve how safety concerns are handled — no individual answers will be shared. If you're dealing with something difficult right now, please talk to a counselor or trusted adult.
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 frequency counts with a matrix question breaking down safety by specific locations (hallways, bathrooms, classrooms, etc.), not just an overall safety score
- Includes an AI follow-up interview that reconstructs a student's most vivid unsafe incident in detail and probes exactly what would make them more likely to report future incidents — something a fixed question list can't do
- Pairs perception data (safety, trust in adults) with a MaxDiff prioritization question so schools can see which interventions students believe would actually help most
- Anonymous by design, with open-ended space for students to add context adults might be missing, and an auto-generated report to turn responses into actionable findings
QuestionPro
School violence survey questions + sample questionnaire templateThis page reads more as a guide with a sample question list than a ready-to-field survey instrument. It covers similar ground (witnessing violence, perceptions of safety) but is presented as reference content rather than a deployable, structured template.
What it does well
- Backed by an established enterprise survey platform with broad distribution and reporting tools
- Provides a sample questionnaire covering multiple facets of school violence
Where it falls short
- Presented as a blog/guide-style sample rather than a structured, fielding-ready template
- No adaptive AI follow-up — questions are static and identical for every respondent
- No per-response quality scoring or transparent methodology for how questions were derived
Jotform
School Safety Survey Form TemplateA straightforward, customizable form template built on Jotform's drag-and-drop form builder. It's practical for quickly collecting basic safety feedback but is a static form rather than an interview-style research instrument.
What it does well
- Easy to customize via Jotform's drag-and-drop builder
- Simple to deploy quickly and integrates with Jotform's broader form ecosystem
Where it falls short
- Static question set with no adaptive follow-up based on a student's answers
- No voice or AI-driven interview component to explore specific incidents in depth
- No automated quality scoring of open-ended responses
SurveyMonkey
School Climate Survey TemplateA standard SurveyMonkey template addressing general school climate, likely including safety-adjacent items alongside broader climate questions. It benefits from SurveyMonkey's mature distribution and analytics but is a fixed-question instrument.
What it does well
- Backed by a well-known survey platform with strong distribution and dashboard analytics
- Likely benchmarkable against other SurveyMonkey climate templates
Where it falls short
- No adaptive AI interview to probe a specific safety incident in a student's own words
- Static, one-size-fits-all question flow with no branching based on individual experience
- No transparent, publishable methodology for how follow-up depth is determined (there isn't any)
SurveySparrow
Free School Climate Survey Template | For StudentsSurveySparrow's conversational, chat-style format may feel more approachable to students than a traditional grid survey. However, the conversational UI is a scripted front-end, not an adaptive interview that reacts to what a student actually reports.
What it does well
- Chat-style conversational format may improve completion rates among students
- Free template lowers the barrier to trying it out
- Mobile-friendly presentation suited to a younger audience
Where it falls short
- Conversational UI is pre-scripted, not an AI system that dynamically follows up on a specific disclosed incident
- No voice AI interview option or automated per-response quality scoring
- No transparent documentation of question logic or prompt design
Ready to launch?
Open this template in the editor. Every part is yours to change before the first respondent sees it.