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Environmental Issues Survey Form Template

Gather valuable insights on environmental concerns

Are you struggling to understand community concerns about the environment? This template is designed for organizations and agencies looking to gather insightful feedback on environmental issues. You can identify key problems, measure public opinion, and increase awareness, all while ensuring participants can engage easily with WCAG-aligned labels. Discover how this survey can help you make informed decisions.

Do you consent to your responses being used for research and improvement purposes?
Yes
No
What is your age?
Under 18
18-24
25-34
35-44
45-54
55-64
65+
Prefer not to say
City/Town and country (optional)
What is your gender?
Woman
Man
Non-binary
Prefer to self-describe
Prefer not to say
Which environmental issues are most important to you? Select up to three.
Please Specify:
I am concerned about the impact of environmental issues on my community.
Strongly disagree
Disagree
Neither agree nor disagree
Agree
Strongly agree
How often do you follow news about environmental issues?
Never
Rarely
Sometimes
Often
Always
I separate waste for recycling.
Never
Rarely
Sometimes
Often
Always
I reduce energy use at home (e.g., turning off lights, efficient heating/cooling).
Never
Rarely
Sometimes
Often
Always
I avoid single-use plastics when possible.
Never
Rarely
Sometimes
Often
Always
How likely are you to volunteer time for an environmental cause in the next 6 months?
0 Not at all likely
1
2
3
4
5 Extremely likely
How likely are you to donate money to an environmental cause in the next 6 months?
0 Not at all likely
1
2
3
4
5 Extremely likely
What are the main barriers that prevent you from taking more environmental actions? Select all that apply.
Please Specify:
What would help you do more for the environment? Select all that apply.
Please Specify:
I support investing in renewable energy.
Strongly disagree
Disagree
Neither agree nor disagree
Agree
Strongly agree
I support policies that reduce single-use plastics.
Strongly disagree
Disagree
Neither agree nor disagree
Agree
Strongly agree
Where do you usually get information about environmental issues? Select all that apply.
Please Specify:
Have you participated in any environmental activities in the past 12 months (e.g., clean-ups, tree planting, campaigns)?
Yes
No
Email (optional)
May we contact you about this survey or local opportunities?
Yes
No
Any other comments or suggestions?
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Paper art illustration depicting environmental themes for an article on survey form template by FormCreatorAI

When to use this form

Use this form when you need clear input on recycling, energy use, climate risks, and local conservation. City planners can prioritize projects, nonprofits can fine-tune outreach, schools can shape lessons, and businesses can align ESG goals with staff and customer needs. It is ideal before a grant proposal, a policy update, or a new program launch. To segment audiences before the full rollout, start with a Pre survey form and tailor follow-ups. If you want to trial wording and skip logic with a small group, use the Demo questions and answers form to test flow without touching your live study. You get data you can compare over time and turn into actions, not guesses.

Must Ask Environmental Issues Survey Questions

  1. Which environmental issues are most important to you? (Select up to three)

    This reveals priorities so you focus effort on what matters most. Limiting choices reduces noise and shows clear trade-offs.

  2. How often do you do these actions: recycle, reduce energy use, use public transit, or avoid single-use plastics?

    Behavior data is more predictive than opinions. Frequencies help you measure baselines and track change after programs.

  3. What barriers keep you from making more sustainable choices?

    Barriers like cost, time, or access point to fixes you can deliver. Knowing obstacles guides targeted incentives and support.

  4. How would you like to take part in local initiatives? (Events, volunteering, online input, budget support)

    Preferred channels tell you where to invest outreach. Offering concrete options increases response rates and future participation.

  5. What resources would help you reduce your environmental impact in the next three months?

    Time-bound needs produce actionable requests you can fulfill fast. You can also invite open ideas via the Content idea suggestion form to capture specifics in respondents' own words.

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