Road Maintenance Feedback Survey

Road Maintenance Feedback Survey — Form Fields

This surveys template includes 9 fields. Collect resident feedback on road quality, pothole response times, and street maintenance. Free to customize and use on ZenBuild.

• Street or Area (optional) (text, optional)
• Issue Frequency (dropdown selection, required) — options: Constant, Often, Sometimes, Rarely
• Overall Road Quality in Your Area (rating, required)
• Speed of Pothole Repairs (rating, required)
• Street Lighting Quality (rating, required)
• Have you reported a road issue before? (multiple choice, required) — options: Yes, No
• Was your report acted upon? (multiple choice, required) — options: Yes, Partially, No, Not Applicable
• Issues Observed (checkboxes, optional) — options: Potholes, Cracking, Poor Drainage, Faded Markings, Missing Signs, Poor Lighting
• Specific Road Issues to Report (long text, optional)