Beneficiary Feedback Form

Beneficiary Feedback Form — Form Fields

This nonprofit template includes 6 fields. Capture direct feedback from the individuals and families your organization serves. Provides insight into service quality, dignity of care, and unmet needs. Essential for participant-centered program improvement. Free to customize and use on ZenBuild.

• Which service did you receive? (dropdown selection, required) — options: Food Assistance, Housing Support, Job Training, Counseling, Childcare, Other
• How satisfied were you with the service you received? (rating, required)
• How would you rate the respect and dignity shown by our staff? (rating, required)
• Did the service meet your immediate need? (multiple choice, required) — options: Yes, fully, Partially, No
• What could we do better? (long text, optional)
• Would you return to us for services in the future? (multiple choice, optional) — options: Yes, No, Not sure