Community Needs Assessment Template
A community organization collects neighborhood needs, service use, access barriers, and suggestions from residents to guide local planning.
When to use it
- Before planning neighborhood programs or services
- When gathering resident input for a community meeting
- To identify barriers to accessing local services
- When reviewing priorities for a community grant or project
What it asks
- What is your name?
- What is your email address?
- What is your phone number?
- Which neighborhood do you live in?
- What are the most pressing needs in your neighborhood?
- Tell us more about the needs you selected, or share another need.
- Which services have you or your household used?
- What barriers make it harder to get the services you need?
- Would you like to explain any barriers you selected?
- What changes or services would make the biggest difference in your neighborhood?
Why it should be encrypted
Answers may reveal contact details, where someone lives, services their household uses, and challenges they face. Keep them from being read by people who do not need access, including SealForm.
Tips
- Make name, email, and phone optional if you want responses without identifying details.
- List local services and barriers people are likely to recognize, with an “Other” option.
- Explain who will review responses and how you’ll use them.