Consumer Financial Confidence, Savings & Debt Stress Survey
Measures household financial confidence, savings buffer adequacy, debt stress, and behavioral coping strategies. Designed for consumer research panels to track financial resilience and segment by financial health.
Sample questions
A preview of what’s in the template. Every question is editable before you launch.
How confident are you in your household's financial situation over the next 12 months?
Do you currently have any liquid savings you could access within 7 days?
- Yes
- No
Do you currently carry any debt (e.g., credit cards, loans, BNPL)?
- Yes
- No
Which of the following actions, if any, have you taken to manage your cash flow in the last 30 days? Select all that apply.
- Delayed a planned purchase
- Used savings to cover expenses
- Carried a balance on a credit card
- Borrowed from friends or family
- Used Buy Now, Pay Later (BNPL)
- Postponed a bill payment
- None of the above
Based on your responses in this survey, is there anything else you'd like to share about your current financial situation or the decisions you're making?
What is your age?
- 18–24
- 25–34
- 35–44
- 45–54
- 55–64
- 65 or older
- Prefer not to say
Thank you for completing this survey. Your responses have been recorded and will be treated confidentially. We appreciate your time.
Over the next 6 months, do you expect your total household income to:
- Increase
- Stay about the same
- Decrease
- Not sure
Approximately how many months of essential expenses could your current savings cover?
- 0 — no savings buffer
- Less than 1 month
- 1–2 months
- 3–5 months
- 6–11 months
- 12 months or more
- Not sure
Which types of debt do you currently have? Select all that apply.
- Credit card balance
- Auto loan/lease
- Student loan
- Mortgage/home loan
- Personal loan
- Buy Now, Pay Later (BNPL)
- Overdraft
- Other
If you received an extra 100 units of your local currency this month, how would you prioritize spending it? Please rank from highest to lowest priority.
- Short-term savings / emergency fund
- Debt repayment
- Essential expenses
- Discretionary spending
- Investing / long-term goals
We'd like to understand your financial decisions in a bit more depth. An AI moderator will ask you a couple of brief follow-up questions based on your earlier responses.
What is your gender?
- Man
- Woman
- Non-binary
- Prefer not to say
Compared with 12 months ago, would you say your financial cushion (savings relative to expenses) is:
- Stronger
- About the same
- Weaker
- Not sure
In the last 3 months, how often did you add money to savings?
- Weekly
- Monthly
- Less than monthly
- Not at all
In the last 30 days, how stressed have you felt about your debt obligations?
Where do you currently live?
- United States
- United Kingdom
- Canada
- Australia
- Europe
- India
- Other
How confident are you that you will reach your savings goals this year?
How difficult is it for you to make your required minimum payments this month?
What is the highest level of education you have completed?
- Some high school or less
- High school diploma or equivalent
- Some college / associate degree
- Bachelor's degree
- Postgraduate degree
- Prefer not to say
Have you missed or been late on any bill or loan payment in the last 90 days?
- Yes
- No
- Prefer not to say
What is your current employment status?
- Employed full-time
- Employed part-time
- Self-employed
- Unemployed and looking
- Unemployed and not looking
- Student
- Retired
- Prefer not to say
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 quantitative confidence, savings-buffer, and debt-stress scales with a dedicated AI follow-up interview that probes the reasoning behind each household's financial decisions in more depth
- Includes a ranking exercise on how respondents would allocate a hypothetical windfall, giving behavioral insight beyond simple multiple-choice questions
- Captures coping behaviors (missed payments, cash-flow actions) alongside financial health metrics, enabling segmentation by financial resilience and demographics
- Backed by transparent, inspectable prompts and automated report generation, available on a free tier or the $50/mo Business plan
Jotform
Four-Minute Financial Health Check Form TemplateA short, fielding-ready static form aimed at quickly gauging a respondent's financial health rather than deep behavioral segmentation. It's built for speed and simplicity rather than depth of insight into debt stress or coping strategies. Good for a lightweight check-in, but lacks the structured savings/debt/coping-behavior breakdown QuestionPunk's template provides.
What it does well
- Fast, low-friction form intended to be completed in a few minutes
- Standard Jotform drag-and-drop builder with mobile-friendly layouts
- Likely easy to embed or share via link for quick pulse checks
Where it falls short
- Static question set with no adaptive AI follow-up to probe individual financial situations further
- No automated per-response quality scoring or AI-generated report synthesis
- No voice-based interview option or guided screen-share task capability
Ready to launch?
Open this template in the editor. Every part is yours to change before the first respondent sees it.
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