Q01
Message
All templates
Quality of Life & Wellbeing Assessment Survey
Captures how people rate their overall life satisfaction alongside specific domains — health, finances, work, relationships, and community — then uses an AI follow-up to dig into whichever domain is dragging scores down. Built for wellbeing researchers, HR teams, city planners, and health programs that need both the numbers and the lived reasons behind them.
Sample questions
A preview of what’s in the template. Every question is editable before you launch.
14 questions · ~7 min
Q02
Opinion ScaleRequired
Overall, how satisfied are you with your life right now?
Scale: 0 – 10
Min:Extremely dissatisfiedMax:Extremely satisfied
Q03
MatrixRequired
How satisfied are you with each of the following areas of your life?
7 rows × 5 columns
- Physical health
- Mental and emotional wellbeing
- Financial situation
- Work or career
- Relationships and social life
- +2 more
Columns: Very dissatisfied · Dissatisfied · Neutral · Satisfied · Very satisfied
Q04
Number
On average, how many hours of sleep did you get per night over the past week?
Q05
Multiple ChoiceRequired
In the last 7 days, on how many days did you get at least 8 minutes of physical activity?
- 0 days
- 1-2 days
- 3-4 days
- 5-6 days
- Every day
Q06
Opinion ScaleRequired
Thinking about the last 30 days, how would you rate your overall stress level?
Scale: 1 – 10
Min:No stress at allMax:Extreme stress
Q07
Multiple ChoiceRequired
In a typical week, how often do you have meaningful contact (in person or by phone/video) with people you feel close to?
- Daily
- A few times a week
- About once a week
- A few times a month
- Rarely or never
Q08
Best–Worst Trade-off (MaxDiff)Required
Which of these areas would most improve your quality of life if it got better, and which matters least to you right now?
- Physical health
- Financial security
- Career or work satisfaction
- Relationships and social connection
- Personal growth or learning
- Leisure and hobbies
- Living environment
- Sense of purpose or meaning
Pick best & worst per setBest:Most impactfulWorst:Least impactful
Q09
Rating Scale
How would you rate your neighborhood or community as a place to live?
Range: 1 – 5
Min:PoorMax:Excellent
Q10
AI Interview
Identify the respondent's lowest-rated life domain from the earlier ratings (or their highest-stress area) and probe concretely: what specifically is going wrong day to day, when it started, and what has stopped them from improving it. If they rated everything similarly moderate, ask what a noticeably better week would look like in practice. Anchor on real recent examples, not general feelings.
Q11
Multiple Choice
Which age range do you fall into?
- Under 18
- 18-24
- 25-34
- 35-44
- 45-54
- 55-64
- 65 or older
- Prefer not to say
Q12
Multiple Choice
How do you describe your gender?
- Woman
- Man
- Non-binary
- Prefer to self-describe
- Prefer not to say
Q13
Multiple Choice
Which best describes your current employment status?
- Employed full-time
- Employed part-time
- Self-employed
- Unemployed and looking
- Student
- Retired
- Unable to work
- Prefer not to say
Q14
Message
Thank you for sharing this with us. Your responses will be combined with others (never shared individually) to identify where wellbeing support is needed most and to track how it changes over time.
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
- Combines a single overall life-satisfaction rating with a matrix covering health, finances, work, relationships, and community, so you get both a headline number and domain-level detail in one flow
- Includes an AI follow-up interview that automatically identifies each respondent's lowest-rated domain and asks targeted, context-aware questions to surface the 'why' behind low scores — something static forms can't do
- Pairs objective wellbeing proxies (sleep hours, physical activity days, stress rating, social contact frequency) with a MaxDiff priority question, so results show not just satisfaction but what would move the needle
- Built-in demographic screening (age, gender, employment status) plus transparent, auditable AI prompts and auto-generated reporting, all on a platform with a free tier and $50/mo Business plan — no hidden academic tier
Jotform
Quality of Life Survey Form TemplateA static, fielding-ready form template built on Jotform's drag-and-drop form builder, likely covering standard life-domain questions. It's easy to customize and embed but relies entirely on fixed questions with no dynamic follow-up logic based on individual answers.
What it does well
- Simple drag-and-drop customization within Jotform's broad form-builder ecosystem
- Likely supports embedding, file/media fields, and integrations common to Jotform templates
Where it falls short
- Static question set with no adaptive follow-up probing into a respondent's specific low-scoring domain
- No published methodology for how questions map to reporting or scoring, and no voice-interview option
QuestionPro
Quality of life surveyA template from a full-featured survey platform with strong analytics and reporting tools, positioned for research and CX use cases. The template itself appears to be a fixed question set rather than one that adapts based on a respondent's individual pattern of answers.
What it does well
- Backed by a research-oriented platform with robust cross-tabulation and reporting features
- Broad question-type library suitable for building out life-domain matrices and scales
Where it falls short
- No adaptive AI interviewing — follow-up questions, if any, are pre-scripted rather than generated from the respondent's lowest-rated domain
- No transparent, per-response prompt methodology or automated qualitative probing published on the page
SurveySparrow
Quality of Life Survey TemplatePositioned in SurveySparrow's healthcare template category, this uses their conversational chat-style survey format, which can feel more engaging than a plain form. However, the conversational tone is scripted UI styling, not AI-generated follow-up based on actual response content.
What it does well
- Conversational, chat-like UI that may improve completion rates versus a traditional grid form
- Positioned specifically for healthcare/wellbeing use cases
Where it falls short
- Chat-style presentation is a fixed script, not an AI system that dynamically probes whichever domain scored lowest
- No voice-interview mode or automated per-response quality scoring described
SurveyMonkey
Work Life Balance Survey Template & QuestionsThis template focuses specifically on work-life balance rather than the fuller quality-of-life scope (health, finances, community, relationships), so it's a narrower but adjacent comparison. It's a ready-to-field static template built on SurveyMonkey's established survey infrastructure.
What it does well
- Narrow, focused question set specifically for work-life balance topics
- Built on SurveyMonkey's mature distribution and basic reporting tools
Where it falls short
- Scope is limited to work-life balance and doesn't cover the broader domain set (finances, community, health) that a full quality-of-life assessment needs
- Static question flow with no AI-driven follow-up to explore why a specific domain is dragging scores down
Ready to launch?
Open this template in the editor. Every part is yours to change before the first respondent sees it.