A structured needs assessment for local governments and nonprofits to identify residents' service priorities, access barriers, and communication preferences to guide resource allocation.
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
Template Overview
23
Questions
AI-Powered
Smart Analysis
Ready-to-Use
Launch in Minutes
This professionally designed survey template helps you gather valuable insights with intelligent question flow and automated analysis.
Sample Survey Items
Q1
Chat Message
Welcome to the Community Service Needs Assessment.
This survey asks about your experience with local services, the issues that matter most to you, and any barriers you have encountered. Your honest opinions will help inform local planning and resource decisions.
• Participation is entirely voluntary. You may stop at any time.
• There are no right or wrong answers — we want your genuine perspective.
• Your responses are confidential and will only be reported in aggregate.
• Estimated time: 8–10 minutes.
Please read the consent question on the next screen to continue.
Q2
Multiple Choice
Do you voluntarily agree to participate in this survey?
I agree to participate
I do not agree
Q3
Multiple Choice
Which best describes your connection to this community?
I live here
I don't live here, but I work or study here
I do not live, work, or study here
Q4
Multiple Choice
Which of the following community services have you personally used in the last 12 months? Select all that apply.
Healthcare/clinics
Mental health counseling
Public transit
Job training or employment services
Childcare/early learning
Housing assistance
Parks/recreation programs
Senior services
Library or public internet
Waste and recycling
Public safety services (non-emergency)
None of the above
Other
Q5
Opinion Scale
Overall, how satisfied were you with the community services you used in the last 12 months?
Range: 1 – 7
Min: Very dissatisfiedMid: NeutralMax: Very satisfied
Q6
Opinion Scale
Thinking about the last 12 months, how easy or difficult was it overall to access the community services you needed?
Range: 1 – 7
Min: Very difficultMid: NeutralMax: Very easy
Q7
Multiple Choice
Which barriers have you personally faced when trying to use community services in the last 12 months? Select all that apply.
Not aware of what's available
Hours don't fit my schedule
Transportation challenges
Cost or fees
Eligibility rules/documentation
Language barriers
Internet or device access
Childcare responsibilities
Physical accessibility
Concerns about privacy or stigma
Waitlists or delays
Staff responsiveness
Quality concerns
None of the above
Other
Q8
Ranking
Please rank the following local issues by priority for the next 12 months. Drag to reorder (1 = highest priority).
Drag to order (top = most important)
Affordable housing
Public safety (non-emergency)
Healthcare access
Mental health and substance use support
Jobs and skills training
Childcare/early learning
Public transit and mobility
Q9
Opinion Scale
How urgently do you feel local services need to change over the next 12 months?
Range: 1 – 7
Min: Not at all urgentMid: NeutralMax: Extremely urgent
Q10
Multiple Choice
How would you prefer to hear about local services and events? Select all that apply.
Text/SMS
Email newsletters
Local social media groups
Posters/flyers in community spaces
Community organizations/faith groups
City or county website
Local newspaper/radio
Word of mouth
Other
Q11
Opinion Scale
In the last 12 months, how easy or difficult has it been to reach the right office or person when you needed help?
Range: 1 – 7
Min: Very difficultMid: NeutralMax: Very easy
Q12
Dropdown
About how long do you usually travel one-way to reach the community services you use most?
Less than 10 minutes
10–19 minutes
20–29 minutes
30–44 minutes
45–59 minutes
60 minutes or more
I don't travel to services (online/phone only)
Not applicable
Q13
AI Interview
We'd like to understand your experience with community services in more depth. Please share what has worked well or what could be improved, and our moderator will ask a few follow-up questions.
AI InterviewLength: 3Personality: [Object Object]Mode: Fast
Reference questions: 4
Q14
Long Text
Based on your responses in this survey, is there anything else you would like to share about your community's needs or services?
Max chars
Q15
Long Text
What is your ZIP or postal code?
Max chars
Q16
Long Text
What is your neighborhood or nearest cross-streets? (optional)
Max chars
Q17
Dropdown
What is your age group?
Under 18
18–24
25–34
35–44
45–54
55–64
65 or older
Prefer not to say
Q18
Multiple Choice
How do you describe your gender?
Woman
Man
Non-binary
Prefer to self-describe
Prefer not to say
Q19
Dropdown
What is the highest level of education you have completed?
Some high school or less
High school diploma or GED
Some college/associate degree
Bachelor's degree
Postgraduate or professional degree
Prefer not to say
Q20
Multiple Choice
What is your current employment situation? Select all that apply.
Employed full-time
Employed part-time
Self-employed
Unemployed and looking
Student
Retired
Homemaker/caregiver
Unable to work
Prefer not to say
Q21
Dropdown
Including yourself, how many people live in your household?
1 (just me)
2
3
4
5
6
7 or more
Prefer not to say
Q22
Dropdown
How long have you lived in this community?
Less than 6 months
6–12 months
1–3 years
3–5 years
More than 5 years
Q23
Chat Message
Thank you for completing the survey. Your responses are confidential and will help inform local planning and resource allocation. If you have questions about this study, please contact [organization name and contact information].
Frequently Asked Questions
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AI interviews conduct adaptive conversations with respondents. The AI asks follow-up questions based on what the respondent says, probing for clarity and depth. You control the personality, tone, model (Haiku, Sonnet, or Opus), and question mode (fixed count, AI decides when to stop, or time-based).
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