Community needs assessment survey template

Fifteen questions. Anonymous. Results by group show only when at least 5 people answered. Questions: How easy is it to get these? Rank the needs that matter most. Which area do you live in? Who lives in your household? I feel part of the community. I know where to go for help. Services are easy to reach. My voice is heard locally. How was your area then and now? How safe do you feel after dark? What would help most? How do you hear about local news? Would you help make a change? What is the biggest thing missing? Anything else you want to say?