Q01
Message
All templates
Disaster Preparedness and Response Readiness Survey
Assesses how prepared people actually felt, what emergency communications and procedures worked, and where gaps showed up during a real event or drill. Built for emergency management teams, facilities, and HSE departments benchmarking readiness, with an AI follow-up that reconstructs exactly what happened during the respondent's most recent disaster or drill instead of relying on general perceptions.
Sample questions
A preview of what’s in the template. Every question is editable before you launch.
13 questions · ~7 min
Q02
Multiple ChoiceRequired
Which of the following best describes your most recent experience with an emergency or disaster event in the past 12 months?
- A real disaster or emergency (e.g., fire, flood, storm, earthquake)
- A scheduled emergency drill or exercise
- Both a real event and a drill
- Neither - no experience in the past 12 months
Q03
Opinion ScaleRequired
Before that event or drill began, how prepared did you feel to respond appropriately?
Scale: 1 – 7
Min:Not prepared at allMax:Extremely prepared
Q04
MatrixRequired
Thinking about that same event, how would you rate each of the following?
5 rows × 5 columns
- Clarity of evacuation or shelter-in-place instructions
- Timeliness of alerts and warnings
- Availability of emergency supplies (first aid, water, flashlights, etc.)
- Communication from leadership or emergency coordinators
- Support and resources available during recovery
Columns: Poor · Fair · Good · Very good · Excellent
Q05
Multiple ChoiceRequired
At the time of the event, did you know your designated evacuation route or emergency assembly point?
- Yes, clearly
- Somewhat, but I hesitated
- No, I did not know
- Not applicable - no evacuation was required
Q06
Rating ScaleRequired
How would you rate the clarity of the emergency alerts you received (text, siren, app notification, PA announcement, etc.)?
Range: 1 – 5
Min:Very unclearMax:Very clear
Q07
Best–Worst Trade-off (MaxDiff)Required
Which of these improvements would matter most to your safety and confidence in a future emergency? Choose the most and least important each round.
- Faster alert and warning systems
- Clearer evacuation signage and routes
- More frequent emergency drills
- Better-stocked emergency supplies and shelters
- Improved communication from leadership during events
- Stronger coordination with local emergency services
- More accessible support for people with mobility or health needs
- Better post-disaster recovery and support resources
Pick best & worst per setBest:Most importantWorst:Least important
Q08
Point AllocationRequired
If you had 100 points to invest in improving disaster readiness, how would you split them across these areas?
- Alert and warning systems
- Training and drills
- Physical infrastructure (shelters, signage, exits)
- Communication tools and coordination
- Post-disaster recovery and support services
Allocate 100 points
Q09
AI Interview
Reconstruct exactly what happened for this respondent during the specific event or drill they described: what alert or instruction they first received, what they did step by step, and where confusion or delay occurred. If they said they didn't know their evacuation route or rated communication poorly, probe concretely what information was missing and what would have changed their behavior in the moment.
Q10
Long Text
What is the one change that would have most improved your confidence or safety during that event?
Q11
Multiple Choice
Which best describes your role during emergencies at your organization or community?
- General staff/resident with no formal emergency role
- Designated warden, marshal, or first responder
- Facilities, safety, or emergency management staff
- Manager or leadership responsible for coordinating response
- Prefer not to say
Q12
Short Text
Which site, building, or region were you in during that event? (Optional - helps us localize improvements)
Q13
Message
Thank you for sharing your experience. Your answers will feed directly into updating our emergency alerts, drills, and response procedures - no individual responses will be shared outside the safety team.
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
- Uses an AI follow-up interview to reconstruct exactly what happened during the respondent's most specific recent event or drill, rather than relying on general recall or checkbox ratings
- Combines structured measurement (opinion scale, matrix, rating, max-diff, constant-sum) with open-ended probing, so readiness gaps show up in both the numbers and the narrative
- Captures role, location, and prior knowledge of evacuation routes/procedures so emergency management teams can segment results by site, building, or region
- Every prompt is transparent and results roll up into an auto-generated report, so HSE teams can see exactly what was asked and why a gap was flagged
Jotform
Disaster Management Checklist Form TemplateThis is a checklist-style form for tracking disaster management tasks and resources rather than a perception/readiness survey. It's built for quick data capture and customization within Jotform's drag-and-drop builder, not for reconstructing what happened during a specific event.
What it does well
- Easy to customize within Jotform's form builder
- Simple checklist format suited for operational tracking
- Free to start using like most Jotform templates
Where it falls short
- Static checklist with no adaptive follow-up questions to probe individual experiences
- No mechanism to reconstruct a respondent's specific recent event or drill
- No automated per-response quality scoring or generated readiness report
QuestionPro
Disaster Management Survey Questions + Sample Questionnaire TemplateThis page reads as a guide with sample questions and a downloadable questionnaire rather than a ready-to-field adaptive survey. It's useful as a reference for question ideas but requires manual assembly into a live survey instrument.
What it does well
- Broad library of sample disaster management questions to draw from
- Backed by an established survey platform with wide question-type support
- Free sample questionnaire available for reference
Where it falls short
- Presented as a static question list/guide rather than a fielding-ready adaptive interview
- No AI-driven follow-up to reconstruct a respondent's actual recent event
- No published methodology for scoring response quality
SurveySparrow
Disaster Recovery Plan QuestionnaireA conversational-style questionnaire template focused on disaster recovery planning, fielded through SurveySparrow's chat-like survey format. It's ready to deploy but relies on fixed question paths rather than dynamic, event-specific probing.
What it does well
- Conversational UI that can feel more engaging than a traditional form
- Ready-to-use template within SurveySparrow's business template library
- Supports standard question types like rating and multiple choice
Where it falls short
- No adaptive AI follow-up to dig into what specifically happened during a respondent's event or drill
- No voice AI interview option or guided screen-share tasks
- No automated per-response quality scoring or transparent prompt methodology
Ready to launch?
Open this template in the editor. Every part is yours to change before the first respondent sees it.