SayPro Feedback Collection Template: A digital or printable template designed for gathering feedback from community members

SayPro Feedback Collection Template

The SayPro Feedback Collection Template is designed to gather valuable input from community members in a structured and easy-to-complete format. This template can be used in digital formats (e.g., Google Forms) or as a printable paper form. It ensures that feedback is collected consistently, allowing the SayPro Community Development Office (CDO) to analyze and act on the community’s responses effectively.

SayPro Feedback Collection Template

1. General Information

(Optional section for demographic data to help analyze responses by various community segments)

• Name: ______________________________________
• Age:
  • Under 18
  • 18–24
  • 25–34
  • 35–44
  • 45–54
  • 55+
• Gender:
  • Male
  • Female
  • Non-binary
  • Prefer not to answer
• Location/Neighborhood: ________________________
• How long have you lived in this community?
  • Less than 1 year
  • 1–5 years
  • 6–10 years
  • More than 10 years
• Preferred Language for Communication:
  • English
  • Spanish
  • Mandarin
  • Other (please specify): _______________

2. Community Services Feedback

Please rate your satisfaction with the following community services offered by SayPro.

Healthcare Services

• How satisfied are you with the availability of healthcare services in the community?
  • Very Satisfied
  • Satisfied
  • Neutral
  • Dissatisfied
  • Very Dissatisfied
• Any specific suggestions to improve healthcare services?
  • ___________________________________________________________

Youth Engagement & Education

• How would you rate the youth programs and educational initiatives available in the community?
  • Excellent
  • Good
  • Fair
  • Poor
  • Very Poor
• What types of youth programs would you like to see more of?
  • ___________________________________________________________

Community Events & Activities

• How satisfied are you with the variety of community events (e.g., festivals, sports events, cultural activities)?
  • Very Satisfied
  • Satisfied
  • Neutral
  • Dissatisfied
  • Very Dissatisfied
• What types of events or activities would you like to see more of in the future?
  • ___________________________________________________________

Public Safety & Security

• How safe do you feel in the community?
  • Very Safe
  • Safe
  • Neutral
  • Unsafe
  • Very Unsafe
• What improvements would you suggest for enhancing public safety in the community?
  • ___________________________________________________________

3. General Feedback & Suggestions

• What do you think are the greatest strengths of the community development programs in your area?
  • ___________________________________________________________
  • ___________________________________________________________
• What areas do you believe need improvement?
  • ___________________________________________________________
  • ___________________________________________________________
• Are there any additional comments or concerns you would like to share?
  • ___________________________________________________________
  • ___________________________________________________________

4. Participation in Future Activities

• Would you be interested in attending future community meetings to discuss community development?
  • Yes
  • No
  • Maybe
• What would make it easier for you to participate in future feedback events?
  • More flexible meeting times
  • Childcare services available
  • Transportation assistance
  • Virtual/online participation options
  • Other (please specify): _______________

5. Consent and Acknowledgement

• Consent to Use Feedback
  • I agree that my feedback can be used anonymously to improve community development programs.
  • I would like to be contacted for follow-up on my feedback (Optional). Please provide your contact details if yes:
  • ___________________________________________________________

Thank you for taking the time to provide feedback! Your input is valuable and will help us improve community programs and services.

Notes for Employees Collecting Feedback:

1. Digital Collection:
   • This template can be easily converted into a digital form (Google Forms, SurveyMonkey, etc.). Ensure that each section is clearly labeled and that options like drop-downs, checkboxes, and text fields are used to make it easy for respondents to complete.
2. Paper Forms:
   • If using paper forms, ensure they are printed clearly with sufficient space for written responses. Have employees or volunteers available to assist those who may need help filling out the form.
3. Accessibility Considerations:
   • Ensure the form is accessible to people with disabilities, including providing larger text or alternative formats (e.g., braille) where needed.
4. Collection Process:
   • Provide multiple ways for community members to submit their feedback, such as during in-person meetings, via email, or through drop-off boxes at local centers.

The SayPro Feedback Collection Template ensures that community members can provide their input in an organized and meaningful way, which is critical for improving SayPro’s programs and services.