About this template
Understanding a client's support system is essential for effective counseling, therapy, and social work planning. This free Social Support Survey template helps mental health professionals, social workers, and counselors evaluate the quality, availability, and reliability of support networks in their clients' lives. By capturing structured insights into personal relationships and perceived social backing, practitioners can tailor their care plans to address isolation or interpersonal stress.
The form collects vital background information alongside detailed matrices measuring how often specific types of emotional and practical support are available to the respondent. Whether used in clinical intake, ongoing client evaluations, or community health research, this digital questionnaire streamlines feedback collection.
Built for seamless deployment via Doc2Form, you can instantly turn this template into a ready-to-use Google Form. Share it securely with clients via email or link, and automatically organize incoming responses in Google Sheets for quick analysis and reporting.
Key features
- Evaluate availability of emotional, practical, and social support
- Collect confidential client feedback and relationship insights
- Organize response data automatically in Google Sheets
- Easily customizable questions to fit specific clinical or research needs
- Mobile-friendly layout for quick completion on any device
Use cases
- Initial intake assessments for counseling and therapy practices
- Client progress tracking during long-term social work programs
- Community health research on interpersonal relationships and isolation
- Support group evaluations and wellness program planning
What this form collects
- Full Name (Short answer)Enter your first and last name, or leave blank if you prefer to submit anonymously.
- Age (Short answer)Enter your current age in years.
- Gender Identity (Dropdown)Select the option that best describes your gender identity.
- Support Availability (Multiple choice)Rate how often you have access to the following types of support when you need them.
- Someone to talk to when upset (Multiple choice)How often do you have someone available to listen when you need to vent or share feelings?
- Practical help in a crisis (Multiple choice)How often do you have someone to help with daily tasks or emergencies (e.g., rides, meals, chores)?
- Emotional reassurance (Multiple choice)How often do you receive comfort and encouragement from people around you?
- Overall Relationship Satisfaction (Linear scale)Rate your overall satisfaction with the quality of your current social interactions and relationships.
- Additional Comments or Concerns (Paragraph)Please share any additional thoughts about your support network or specific challenges you are currently facing.
FAQ
What is a social support survey used for?
It is used by mental health professionals and social workers to understand the strength, availability, and quality of a client's interpersonal support network.
Who should fill out this survey?
Clients, patients, or program participants complete this survey to help practitioners gauge their level of social backing and relationship satisfaction.
Can I customize the questions in this template?
Yes. Once you convert this template into Google Forms using Doc2Form, you can freely add, remove, or modify any questions to match your practice.
How do I share this survey with my clients?
You can share your Google Form via a direct link, email invitation, or by embedding it on your secure client portal.
Where are survey responses stored?
All responses are automatically saved in your secure Google Drive account and linked Google Sheets spreadsheet for easy review.
Get this form in your Google Drive
Save a copy to your Google Drive with one click (uses 1 credit). Or build from a PDF or description in the app.