This printable community needs assessment survey helps local governments, nonprofits, and neighborhood associations hear from every resident, including the many who never respond to online forms. It has 40 questions in clearly labeled sections over six pages and takes fifteen to twenty minutes to complete.
What this survey measures
The survey opens with a household profile, then works through the areas that shape daily life in a community: the quality of local housing, its affordability, and how often people struggle with bills; the importance and quality of seven core local services; safety and environmental conditions; transport and access around the area; and how easily residents can reach health and wellbeing services, with questions on their own health and loneliness. A cost of living section asks which everyday costs worry people and what support would help most, and a community life section measures belonging, trust, local activity, and volunteering. A priorities section asks residents to pick their top three priorities for the next five years and score the area as a place to live. Residents then say how confident they are that leaders will act on the results, how they want to hear about next steps, and whether they would join a follow-up meeting, before they describe the biggest issue and the one change they most want to see.
How to use it on paper
Distribute copies at libraries, community centers, town halls, and public events, or mail them with a return envelope. Residents fill the checkboxes with a blue or black pen. Collect the completed 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 flow into your dashboard without manual data entry.
Customize this template
Add your city or organization logo, rename the services to match what your community actually provides, translate the form for multilingual outreach, or add questions about a specific project or budget decision. The paper layout reflows automatically as you edit, and every copy you print stays scannable.
Preview the PDF above, or use this template to start your community needs assessment today.