Q01
Message
All templatesStrategy & Transformation
Change Request Readiness & Stakeholder Impact Survey
Gauges how a specific proposed change request lands with the people it affects — awareness, perceived risk, resource readiness, and willingness to support it — built for change managers, PMOs, and transformation leads preparing a rollout or approval decision. The AI follow-up interview digs into each respondent's single biggest concern and what would turn hesitation into active support.
Sample questions
A preview of what’s in the template. Every question is editable before you launch.
12 questions · ~7 min
Q02
Multiple ChoiceRequired
Which best describes your current awareness of (Replace with name of proposed change request)?
- I haven't heard of it
- I've heard about it but don't know the details
- I understand the basics
- I understand it in detail, including how it affects my role
Q03
Opinion ScaleRequired
How clearly has the reason for this change been communicated to you?
Scale: 1 – 5
Min:Not clear at allMax:Extremely clear
Q04
MatrixRequired
How much do you agree with each statement about this change request?
4 rows × 5 columns
- The timing of this change makes sense
- I will have the resources (time, tools, training) I need to adopt it
- Leadership has been visible and consistent in supporting this change
- I understand exactly what will be different for me day-to-day
Columns: Strongly disagree · Disagree · Neutral · Agree · Strongly agree
Q05
Opinion ScaleRequired
If this change request were approved and rolled out today, how ready is your team to adopt it?
Scale: 1 – 7
Min:Not ready at allMax:Completely ready
Q06
Multiple ChoiceRequired
What's the single biggest risk or concern you have about this change request?
- Impact on my day-to-day workload
- Lack of clarity on the end goal
- Insufficient training or support
- The timeline is too aggressive
- Effect on team roles or headcount
- (Replace with another concern specific to your change request)
- I don't have a concern
Q07
Point AllocationRequired
You have 100 points to allocate. Split them across the types of support below based on what would most help you adopt this change successfully.
- Clearer communication about why this change is happening
- Hands-on training on the new process or tool
- More time before the change takes effect
- Visible sponsorship from leadership
- Extra staffing or resources during the transition
Allocate 100 points
Q08
Opinion ScaleRequired
How likely are you to actively support this change with your team or colleagues, rather than just tolerate it?
Scale: 0 – 10
Min:Not at all likelyMax:Extremely likely
Q09
AI Interview
Explore the respondent's single biggest concern about this change request in depth: what specifically worries them, what evidence or reassurance would ease it, and whether a past change at this organization is shaping their reaction. If they said they have no concerns, probe what would move them from passive acceptance to being an active champion. If their support rating was low, ask the one thing that would raise it.
Q10
Multiple Choice
Which team or department are you part of?
- (Replace with department A)
- (Replace with department B)
- (Replace with department C)
- Prefer not to say
Q11
Multiple Choice
How long have you been with the organization?
- Less than 1 year
- 1-3 years
- 4-7 years
- 8+ years
- Prefer not to say
Q12
Message
Thanks for your candid feedback! We'll use these responses to refine the rollout plan, address the biggest concerns first, and target training and communication where they're needed most.
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
- Opens with a friendly context-setting message and closes with a thank-you/next-steps message, so respondents understand why their input matters and what happens next.
- Combines an opinion scale, a matrix, and a constant-sum question so change managers can measure communication clarity, agreement across multiple statements, and how respondents would allocate support resources — not just a single satisfaction score.
- Includes an AI follow-up interview that digs into each respondent's single biggest concern about the change and what would turn hesitation into active support, surfacing detail a fixed-choice form can't capture.
- Captures department and tenure alongside sentiment questions, so PMOs and transformation leads can segment readiness and risk by team before a rollout or approval decision.
Jotform
Change Request Form TemplateThis is a static intake form for logging a change request (fields like description, justification, requested date) rather than a survey that gauges how stakeholders feel about a proposed change. It's fielding-ready out of the box but built for request capture/tracking, not sentiment or readiness assessment.
What it does well
- Quick to deploy with Jotform's drag-and-drop builder
- Customizable fields and layout for logging request details
- Can plug into Jotform's broader workflow/automation ecosystem
Where it falls short
- No adaptive follow-up questioning — respondents only answer the fixed fields provided
- No automated quality scoring or auto-generated stakeholder-readiness report
- No mechanism to probe the 'why' behind a respondent's concern, since it's a submission form, not an interview
Typeform
Change Request Form TemplateA conversational-style form for capturing a change request one question at a time, which improves completion experience over a plain form but is still a static predefined question set. It's aimed at documenting a request, not measuring stakeholder awareness, risk perception, or willingness to support a change.
What it does well
- Polished, mobile-friendly conversational UI
- Easy to embed and share as a standalone link
- Simple to customize question wording and branding
Where it falls short
- No AI-driven follow-up probing on individual concerns — question flow is fixed for every respondent
- No voice interview option or guided screen-share tasks
- No automated per-response scoring or auto-generated report on readiness/risk
Frequently asked questions
What questions are in the “Change Request Readiness & Stakeholder Impact Survey” template?
The template includes 12 ready-to-use questions, starting with: “Thanks for taking a few minutes on this! Your responses are completely confidential and anonymized. We'd like your hones…” · “Which best describes your current awareness of (Replace with name of proposed change request)?” · “How clearly has the reason for this change been communicated to you?”. The full set is previewed above, and every question is editable.
How long does this survey take to complete?
Respondents typically finish the 12 questions in about 7 minutes.
Can I customize this template?
Yes — every question, answer option, and the ordering is editable before you launch. You can add or remove questions, or ask the AI editor to rework the survey around your research goal.
Is this template free to use?
Yes. Open it in the editor and start customizing right away — no account required to try it, and the free plan covers launching your survey.
Ready to launch?
Open this template in the editor. Every part is yours to change before the first respondent sees it.
Related templates
More studies on similar topics.
Strategy & Transformation
Payroll Change Notice Clarity & Confidence Survey
Measures whether employees actually noticed, understood, and trust a recent payroll change notice (e.g., new pay schedule, provider, or deduction) and how confident they are their next paycheck will be correct — with an AI follow-up that digs into exactly what's still unclear or worrying to the people who need the most help. Built for HR, payroll, and change-management teams rolling out a payroll transition.
View templateStrategy & Transformation
Change Readiness & Adoption Pulse
Before a reorg, tooling migration, or new process lands, measure whether people understand it, believe in it, and feel equipped for it — the three things that decide adoption. The AI interviewer surfaces the concerns people won't put in a comment box, anonymously.
View templateStrategy & Transformation
Organizational Change Readiness & Sentiment Survey
Tracks how employees understand, feel about, and are coping with an active organizational change — reorg, merger, system rollout, or leadership shift. Built for HR and transformation leads, with an AI follow-up that surfaces the concrete 'why' behind sentiment scores instead of generic complaints.
View templateStrategy & Transformation
Pre-Deployment Change Readiness & Risk Assessment
Assesses organizational and technical readiness for infrastructure, application, or data migrations by flagging dependency risks, evaluating rollback preparedness, and measuring stakeholder confidence before go/no-go decisions.
View templateStrategy & Transformation
Digital Transformation Readiness & Change Fatigue Survey
Assesses how ready employees are for digital transformation across tool adoption willingness, skill confidence, process pain points, and change fatigue. Built for operations, IT, and transformation leaders sequencing a rollout. An AI follow-up digs into the specific reason behind hesitation or exhaustion that scale scores alone can't explain.
View templateStrategy & Transformation
Climate Change Awareness, Concern, and Action Survey
Measures how aware, concerned, and behaviorally engaged people are with climate change — from perceived risk and trust in institutions to everyday actions — with an AI follow-up that digs into the gap between stated concern and real-world behavior. Built for sustainability teams, communicators, and researchers tracking public climate sentiment.
View template