Public Consultation Feedback Form
Structured resident input on a proposal: support level, concerns, and alternatives.
5 questions · 1 page · about 3 minutes to answer · fully editable after you start
Consultations drown in unstructured letters that staff must hand-code for months. This form structures the input while keeping room for voice: overall position on the proposal, specific concerns selected and elaborated, impact on the respondent personally, and the constructive question – what alternative or amendment would earn your support.
The result is countable positions plus quotable reasoning, ready for the consultation report – and residents who feel processed fairly rather than filed. Replace [describe the proposal in two or three sentences, with a link to the full details] at the top before you share it.
Template preview
This is a picture of every question as a respondent would see it, so nothing on it can be clicked or typed into. Use this template to get your own editable copy.
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Page 1
Your view on the proposal
We are asking for your views on a proposal before a decision is made. Read the summary below, then tell us what you think and what concerns you most. It takes about 3 minutes. If you need help with a specific matter, please contact us directly, as this form may not be read straight away.
The proposal: [describe the proposal in two or three sentences, with a link to the full details]
Q1.Overall, what is your position on the proposal?*
- Strongly support
- Support with reservations
- Neutral
- Oppose
- Strongly oppose
Q2.What concerns you most about it?
- Traffic and access
- Cost to taxpayers
- Environmental impact
- Character of the area
- Process and consultation itself
- Nothing - I support it
- Other…
Q3.How would this proposal affect you personally?*
Q4.What change or alternative would earn your support?
Q5.Do you live, work or own property in the affected area? Tick all that apply.*
- I live there
- I work there
- I own property there
- None - general interest
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