This example of a User Needs Assessment exercise uses Social Pinpoint's Form tool to create a survey. The heading and subheading is created with the Call to Action tool.

Help us understand your needs

Complete the survey to tell us what your needs and priorities are for a new Leisure Centre

Please tell us who you are by providing us with your first and last name

You have 255 characters left.

Tell us your age.

What is your relationship with the City Required

Tell us about how you interact with the City. Check all that apply.

How often do you do the following activities?
Very often
Group Sport

When thinking about recreation activities in the City, rank the following from which activity is most important to have to least important to have.

  1. Having a swimming / aquatic facility #
  2. Places to cycle #
  3. Places to jog #
  4. Places to connect with others #
  5. Places to relax #
  6. Places to play team sports #
  7. Classes and courses to learn #

On a scale of 1(least important) to 5 (most important) rate how important you think it is for the City to build a new Leisure Centre.