Use this ready-to-deploy survey template to gather resident feedback on micromobility (e-scooter/e-bike) safety, parking, and rules. Takes 6-8 minutes.
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
Where do you primarily live?
Within this city/municipality
In a neighboring community
I visit for work, school, or leisure but do not live here
Prefer not to say
Q2
Multiple Choice
In the last 12 months, have you used an e‑scooter, e‑bike, or similar micro‑mobility in this city at least once?
Yes
No
Q3
Ranking
If you have not used micro‑mobility here, rank the main reasons you haven’t. Put your biggest reason at the top.
Drag to order (top = most important)
Concerns about safety
Lack of protected lanes/routes
Cost or pricing
Parking rules are unclear
Limited availability/coverage
I don’t need it for my trips
Other (not listed)
Q4
Opinion Scale
Based on what you’ve seen or heard in the last 3 months, how safe do you think micro‑mobility is in this city?
Range: 1 – 10
Min: Very unsafeMid: Neither safe nor unsafeMax: Very safe
Q5
Multiple Choice
In the last 30 days, how often have you seen scooters or bikes parked in ways that block sidewalks or ramps?
Often
Sometimes
Rarely
Never
Q6
Multiple Choice
Which types have you used in this city in the last 12 months? Select all that apply.
Shared e‑scooter
Shared e‑bike
Personal e‑scooter
Personal e‑bike
Conventional bicycle
Other
None of the above
Q7
Dropdown
In the last 30 days, how often did you ride micro‑mobility in this city?
Daily or almost daily
3–5 days per week
1–2 days per week
A few times this month
Not in the last 30 days
Q8
Opinion Scale
When riding in this city in the last 3 months, how safe did you feel overall?
Range: 1 – 10
Min: Not at all safeMid: Neither safe nor unsafeMax: Very safe
Q9
Matrix
How safe or unsafe have the following felt in the last 3 months?
Rows
Very unsafe
Unsafe
Neither safe nor unsafe
Safe
Very safe
Well‑lit areas at night
•
•
•
•
•
Protected bike/scooter lanes
•
•
•
•
•
Drivers yielding at turns
•
•
•
•
•
Pavement condition (bumps, potholes)
•
•
•
•
•
Scooter/bike speeds relative to others
•
•
•
•
•
Crossing major intersections
•
•
•
•
•
Q10
Multiple Choice
In the last 12 months in this city, which have you experienced while riding? Select all that apply.
A near‑miss with a vehicle
A near‑miss with a pedestrian
A minor injury (no medical visit)
An injury requiring medical care
Device malfunction or brake issue
Verbal conflict with another road user
None of the above
Q11
Multiple Choice
Attention check: To confirm you are paying attention, please select “Sometimes” below.
Often
Sometimes
Rarely
Never
Q12
Multiple Choice
How clear are the city’s rules about where scooters or bikes may be parked?
Very clear
Somewhat clear
Somewhat unclear
Very unclear
I am not aware of any rules
Q13
Multiple Choice
In the last 3 months, which parking outcomes have you personally had with micro‑mobility in this city? Select all that apply.
Found a designated parking area or corral
Parked on sidewalk without blocking access
Could not find a legal place to park
Received a warning or fine
Device tipped over after parking
Not applicable — did not park in the last 3 months
Q14
Long Text
Briefly describe where parking was difficult or what led to a warning or fine.
Max 600 chars
Q15
Rating
To what extent do you support the city issuing fines for scooters or bikes that block sidewalks or ramps?
Scale: 10 (star)
Min: Do not supportMax: Strongly support
Q16
Matrix
How much do you support or oppose the following approaches to enforcement and education?
Rows
Strongly oppose
Oppose
Neutral
Support
Strongly support
Start with warnings for the first offense
•
•
•
•
•
Escalating fines for repeat offenses
•
•
•
•
•
Impound devices that block sidewalks or ramps
•
•
•
•
•
Focus enforcement at known hotspots
•
•
•
•
•
Require in‑app rider education before first ride
•
•
•
•
•
Q17
Multiple Choice
Are you aware of how to report unsafe riding or improper parking in this city?
Yes, and I have submitted a report
Yes, but I have not reported anything
No, I am not aware of how to report
Q18
Dropdown
What is your age?
Under 18
18–24
25–34
35–44
45–54
55–64
65 or older
Prefer not to say
Q19
Multiple Choice
How do you describe your gender?
Female
Male
Non-binary
Prefer not to say
Q20
Multiple Choice
Which best describes the area where you live?
Downtown/central area
Residential neighborhood near center
Suburban area
Rural or fringe area
Prefer not to say
Q21
Dropdown
What is the highest level of education you have completed?
Less than high school
High school or equivalent
Some college/technical
Bachelor’s degree
Graduate or professional degree
Prefer not to say
Q22
Multiple Choice
What is your current employment status?
Employed full-time
Employed part-time
Self-employed
Student
Homemaker or caregiver
Retired
Unemployed and seeking work
Prefer not to say
Q23
Numeric
How many years have you lived in this city? If less than 1 year, enter 0.
Accepts a numeric value
Whole numbers only
Q24
Multiple Choice
How do you usually get around in this city? Select all that apply.
Walk
Public transit
Drive myself
Ride as a passenger
Micro‑mobility (e‑scooter/e‑bike)
Taxi or ride‑hail
Wheelchair or mobility device
Other
Q25
Long Text
Any suggestions to improve safety, parking, or enforcement for micro‑mobility in this city?
Max 600 chars
Q26
Chat Message
Welcome! Your feedback will help the city improve micro‑mobility. You may skip any question. Thank you for participating.
Q27
AI Interview
AI Interview: 2 Follow‑up Questions on Micro‑Mobility in Your City
AI InterviewLength: 2Personality: Expert InterviewerMode: Fast
Q28
Chat Message
Thank you for your time—your input will help inform safer, more accessible micro‑mobility.
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