Community Development Opinion Assessment Form
Share your opinions and feedback to help improve our community's development initiatives.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
What is your age group?
*
Please Select
Under 18
18-24
25-34
35-44
45-54
55-64
65 or older
How long have you lived in this community?
*
Please Select
Less than 1 year
1-3 years
4-10 years
More than 10 years
I do not live in this community
How satisfied are you with the following aspects of your community?
*
Rows
Very Dissatisfied
Dissatisfied
Neutral
Satisfied
Very Satisfied
Public safety
1
2
3
4
5
Cleanliness
6
7
8
9
10
Public transportation
11
12
13
14
15
Parks and recreation
16
17
18
19
20
Community events
21
22
23
24
25
Access to healthcare
26
27
28
29
30
Educational facilities
31
32
33
34
35
Which areas should be prioritized for future development? (Select up to 3)
*
Affordable housing
Job opportunities
Healthcare services
Education
Public safety
Environmental sustainability
Transportation
Community spaces
Other
How would you rate the overall quality of life in your community?
*
1
2
3
4
5
How likely are you to recommend this community to others?
*
Not at all likely
1
2
3
4
5
6
7
8
9
Extremely likely
10
1 is Not at all likely, 10 is Extremely likely
What is the biggest challenge facing your community today?
Please share any suggestions or ideas you have for improving the community.
Submit Assessment
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