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Nonprofit & Government
Public Feedback Form
Gather public input on programs or services — satisfaction ratings, open comments, and optional follow-up contact.
Use this template8 fields · Free · Customize before publishing
What this form looks like
Preview · not interactivePublic Feedback Form
Gather public input on programs or services — satisfaction ratings, open comments, and optional follow-up contact.
Which service or program is this about?*
Select…▾
Overall satisfaction*
★★★★★
How likely are you to recommend us to someone in need?*
012345678910
What kind of feedback is this?*
Praise or appreciation
Suggestion for improvement
Concern or complaint
Question
Tell us more*
Your name (optional)
Email for follow-up (optional)
Only if you want a response from our team.
Keep my feedback anonymous
Keep my feedback anonymous
When on, we will not use your name in internal reports.
Submit