Citizen Satisfaction Survey Template

Citizen satisfaction survey template with 4 questions covering local services, quality of life, and council priorities.

Use this template

Copy this template into your account, then customize it to suit your needs.

This printable citizen satisfaction survey helps local councils and community boards gather honest feedback from every resident across 4 questions, including people who never respond to online consultations. The form prints on a single sheet and takes about three minutes to complete.

What this survey measures

The questions cover satisfaction with core local services, from the cleanliness of public spaces and road maintenance to parks, waste collection, public safety, and how well the council responds to residents. A single quality-of-life rating gives you a headline measure to track over time, a multiple-choice question shows which services residents value most, and an open comment box lets people tell you exactly what the council should prioritize next.

How to use it on paper

Hand the survey out at town halls, libraries, community centers, and local events, or leave copies at reception with a drop box for completed forms. Residents fill the checkboxes with a blue or black pen. Collect the forms and scan them in batches: PaperSurvey reads the checkbox answers with optical mark recognition and converts the handwritten comments to text automatically, so results appear in your dashboard without any manual data entry.

Customize this template

Add your council logo, rename the services to match your departments, or add questions about specific neighborhoods or programs. Remove any rows you do not need and the paper layout reflows automatically as you edit, so every copy you print stays scannable.

Preview the PDF above, or use this template to start collecting citizen feedback today.

Questions in this template

  1. How satisfied are you with each of the following local services?
  2. How would you rate your overall quality of life in this area?
  3. Which services are most important to you?
  4. What should the council prioritize?

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