Q01
Message
All templatesNonprofit & Civic
Neighborhood Safety Perception & Priorities Survey
A resident-facing survey for local government and public safety offices that measures how safe people feel by time of day, whether streetlighting and infrastructure support that feeling, and how often incidents actually get reported. An AI follow-up probes the specific location and moment behind a resident's lowest safety rating, surfacing concrete detail a scale score alone can't capture.
No sign-up to try · Free to start · No credit card
Sample questions
A preview of what’s in the template. Every question is editable before you launch.
14 questions · ~7 min
Q02
MatrixRequired
How safe do you feel in each of the following situations in your neighborhood?
4 rows × 5 columns
- Walking alone during the day
- Walking alone after dark
- Waiting for public transit or a bus stop at night
- Children playing outside in the daytime
Columns: Very unsafe · Somewhat unsafe · Neutral · Somewhat safe · Very safe
Q03
Opinion ScaleRequired
How would you rate the street lighting in your neighborhood at night?
Scale: 1 – 5
Min:Very poorMax:Excellent
Q04
Multiple ChoiceRequired
In the last 12 months, have you witnessed or experienced something in your neighborhood that felt unsafe (crime, harassment, a hazardous condition, etc.)?
- Yes
- No
- Not sure
Q05
Multiple ChoiceRequired
In the last 12 months, have you reported a safety concern (crime, suspicious activity, a broken streetlight, a hazard) to police, 311, or another local office?
- Yes, I report concerns whenever they come up
- Yes, but only once or twice
- No, I haven't had a reason to
- No, I decided not to even though I had a reason to
Q06
Multiple Choice
If you have ever decided NOT to report a safety concern, what was the main reason?
- Didn't think it would change anything
- Didn't know how or where to report it
- Worried about retaliation or being identified
- Too time-consuming or confusing process
- Language or communication barrier
- This doesn't apply to me
Q07
Best–Worst Trade-off (MaxDiff)Required
Which of these would do the most, and the least, to improve how safe you feel in your neighborhood?
- More street lighting
- Increased police foot or bike patrols
- Neighborhood watch or community safety programs
- Security cameras in public spaces
- Faster response times to 911 or 311 calls
- Youth and after-school programs
- Improved sidewalks and crosswalks
- Cleanup of abandoned buildings or lots
Pick best & worst per setBest:Would improve my safety the mostWorst:Would improve my safety the least
Q08
AI Interview
Anchor on whichever situation the respondent rated lowest in the safety matrix (or their lighting score if that was notably poor) and reconstruct a specific, recent moment behind it: where it happened, what made it feel unsafe, and what they did or didn't do in response. If they said they decided not to report an incident, probe what would have made them report it. If everything was rated safe, ask what has to stay true for that to keep being the case.
Q09
Short Text
Is there a specific street, park, intersection, or location you'd like the city to know about? (Optional)
Q10
Dropdown
Which neighborhood or district do you live in? (Template note: replace with your city's actual list of neighborhoods/zones before launching.)
- (Replace with Neighborhood A)
- (Replace with Neighborhood B)
- (Replace with Neighborhood C)
- Prefer not to say
Q11
Multiple Choice
How long have you lived in this neighborhood?
- Less than 1 year
- 1-5 years
- 6-15 years
- More than 15 years
- Prefer not to say
Q12
Multiple Choice
What is your age range?
- Under 18
- 18-24
- 25-34
- 35-44
- 45-54
- 55-64
- 65+
- Prefer not to say
Q13
Multiple Choice
What is your gender?
- Woman
- Man
- Non-binary
- Prefer to self-describe
- Prefer not to say
Q14
Message
That's everything — thank you! Your responses will be combined with others across the city to guide decisions on lighting, patrols, and safety programs in your area.
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
- Includes an AI follow-up (AI follow-up interview) that anchors specifically on whichever situation the respondent rated lowest in the safety matrix, digging into a concrete location and moment rather than stopping at a scale score
- Pairs a safety-by-situation matrix and a street lighting rating-scale with concrete reporting-behavior questions (witnessed/experienced, reported, reasons for not reporting) to link perceived safety to actual reporting gaps
- Uses a MaxDiff exercise to force-rank which interventions would most improve perceived safety, giving local government a clearer prioritization signal than an open list of options
- Built for the public-sector use case end to end: district dropdown, tenure and demographic questions, a short-answer prompt for naming a specific street/park/intersection, and an auto-generated report for city stakeholders
QuestionPro
University Campus Safety Survey Questions + Sample Questionnaire TemplateThis is a safety-perception template in the same general family as ours, but it's built for a campus population (students/faculty) rather than city residents, so question framing and stakeholder use differ. The page reads as a static sample questionnaire with guidance text rather than a fully adaptive fielding tool.
What it does well
- Focused specifically on campus safety perception, with sample questions tailored to a student/faculty audience
- Backed by QuestionPro's established survey platform with standard distribution and reporting features
- Presented as a ready-to-use sample questionnaire, useful as a starting template
Where it falls short
- No adaptive AI follow-up questioning — respondents can't be probed further on their specific lowest-rated situation or location
- No mention of voice AI interviews or guided screen-share tasks
- No published per-response quality scoring or transparent prompt methodology, and it's not built for a neighborhood/local-government reporting context
Frequently asked questions
What questions are in the “Neighborhood Safety Perception & Priorities Survey” template?
The template includes 14 ready-to-use questions, starting with: “Thanks for taking a few minutes to share how safe you feel in your neighborhood. Your answers help the city decide where…” · “How safe do you feel in each of the following situations in your neighborhood?” · “How would you rate the street lighting in your neighborhood at night?”. The full set is previewed above, and every question is editable.
How long does this survey take to complete?
Respondents typically finish the 14 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.
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