Community Health & Belonging Survey form template
For online communities, this survey scores belonging, activity, and value received. Highly engaged members are invited to become moderators or ambassadors, while disengaged or lonely members reveal a barriers question and route to a personal welcome-back from the community team.
Whatβs in the box
Belonging score
Connection, activity, and value combine into a health score.
Grow your leaders
Engaged members are invited to moderate or ambassador roles.
Win back the drifting
Low scorers reveal barriers and route to a personal re-welcome.
Perfect for
- Community managers
- Membership sites
- Online forums
- Creator communities
Other templates you might like
Browse all β
Employee Engagement (eNPS) Pulse
Measure employee net promoter score and route disengaged staff to a confidential check-in.

Customer Effort Score (CES) Survey
Measure how easy it was to get something done and route high-effort experiences to fix-it teams.

Market Research Segmentation Survey
Profile respondents into buyer segments using a scoring model, then show segment-specific closers.
Start with Community Health & Belonging Survey, ship today
Free forever for up to 1,000 submissions a month. No credit card.
Use this template