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Questionnaire template

Policy Impact Assessment

Assesses how a policy has affected stakeholders, how well it was implemented and what should happen to it next.

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Nonprofit · Political. All Nonprofit templates

Questions in this template

About You

  1. We are reviewing the effects of a recent policy. Please tell us how it has affected you or your organisation; your answers will inform the review and are reported only in aggregate.

  2. Which of these best describes you?

    Choose one:

    • Individual resident
    • Business owner or employer
    • Non-profit or community organisation
    • Public-sector employee
    • Researcher or academic
    • Other

  3. How would you describe yourself?

    Condition: Only when Other was chosen

    Open answer

  4. How familiar are you with this policy?

    Choose one:

    • Very familiar
    • Somewhat familiar
    • I have only heard of it
    • Not familiar

  5. Does this policy affect you or your organisation?

    Choose one:

    • Yes, directly
    • Yes, indirectly
    • No
    • Not sure

Effects of the Policy

  1. Overall, what effect has the policy had on you or your organisation so far?

    Condition: Only for respondents who know the policy

    Choose one:

    • Very negative
    • Somewhat negative
    • No noticeable effect
    • Somewhat positive
    • Very positive
    • Too early to tell

  2. Since the policy took effect, how has each of these changed for you or your organisation?

    Condition: Only for respondents who know the policy

    • Finances
    • Access to services
    • Administrative workload
    • Health and well-being
    • Jobs and employment

    For each row: choose one:

    • Much worse
    • Somewhat worse
    • No change
    • Somewhat better
    • Much better
    • Not applicable

  3. Have you or your organisation had to change the way you work because of the policy?

    Condition: Only for respondents who know the policy

    Choose one:

    • Yes
    • No
    • Not sure

  4. What did you have to change?

    Condition: Only when changes were reported

    Open answer

  5. Have you noticed any effects of the policy that were probably not intended? Please describe them. (optional)

    Condition: Only for respondents who know the policy

    Open answer

How the Policy Was Introduced

  1. How clear was the official guidance on what the policy requires?

    Condition: Only for respondents who know the policy

    Choose one:

    • Very clear
    • Fairly clear
    • Fairly unclear
    • Very unclear
    • I have not seen any guidance

  2. How much do you agree with each statement about how the policy was introduced?

    Condition: Only for respondents who know the policy

    • It has been applied fairly
    • Changes were announced in good time
    • There was enough time to adjust
    • Adequate help was available to those affected

    For each row: choose one:

    • Strongly disagree
    • Disagree
    • Neither agree nor disagree
    • Agree
    • Strongly agree
    • Don't know

Looking Ahead

  1. What do you think should happen to this policy?

    Choose one:

    • Keep it as it is
    • Keep it with changes
    • Replace it with a different approach
    • End it
    • No opinion

  2. If you could change one thing about the policy, what would it be? (optional)

    Open answer

  3. May the review team contact you for a short follow-up conversation?

    Choose one:

    • Yes
    • No

  4. What email address should we use?

    Condition: Only when follow-up contact was agreed

    Open answer