Community Survey form Community Survey form We would like to hear from you. Your views will help the community committee understand the key issues affecting our community and plan future support and activities. All responses are confidential. About You (Optional)Age group: Under 18 18–30 31–50 51–65 65+ Gender: Female Male Prefer not to say Other 1. Health & WellbeingDo you feel there are any health issues affecting the Tanzanian community locally?(Required) Yes No If yes, please tick all that apply:(Required) Physical health (e.g. diabetes, blood pressure) Mental health (stress, anxiety, depression) Women’s health (e.g. menopause, reproductive health) Men’s health (e.g. prostate health) Access to GP or health services Healthy lifestyle (diet, exercise) Other: Health & Wellbeing Other IssueWhat support would you like to see?(Required) 2. Crime & SafetyDo you have any concerns about crime or safety in our area?(Required) Yes No If yes, please specify:(Required) Anti-social behaviour Youth-related issues Theft or burglary Feeling unsafe in public spaces Domestic safety concerns Other Crime & Safety Other IssueWhat could help improve safety?(Required) 3. Economic & Financial IssuesAre there any financial or employment challenges affecting you or your family?(Required) Yes No If yes, please tick:(Required) Employment opportunities Cost of living Access to benefits/support Starting a business Skills and training Other Other Economic & Financial IssuesWhat type of support would be helpful?(Required) 4. HousingDo you face any housing-related challenges?(Required) Yes No If yes, please tick:(Required) High rent / affordability Difficult to access good credit and mortgage Overcrowding Poor housing conditions Difficulty accessing housing Homelessness risk Other Other housing-related challengesWhat support or changes would help?(Required)5. Education & Young PeopleAre there any challenges affecting education or young people in the community?(Required) Yes No If yes, please tick:(Required) School performance Access to tutoring/support/scholarship to private school Access to support for children with Special Needs / school transport Access to Healthcare Planning University or career guidance Youth activities and clubs Language barriers Other Other challenges affecting education or young people in the communityWhat would you like to see improved?(Required)6. Community PrioritiesWhat are the top 3 issues the community committee should focus on? Add Remove7. Community EngagementWould you like to be involved in community activities or events?(Required) Yes No If yes, what are you interested in?(Required) Health workshops Cultural events Youth programmes Business/finance sessions Social gatherings Volunteering Other Other Community Engagement8. Additional CommentsPlease share any other ideas, concerns, or suggestions:
