A social support questionnaire is meant to establish how people within a society associate with one another and enlist other people’s help in need. The surveys carried out through such questionnaires reflect how people in a specific community relate, how they trust each other and the level of actions and support that they give to each other. Such are usually initiated by not-for-profit organizations seeking to initiate community programs that require communities to work together. Overall, the social support questionnaire measures the strengths of a person’s social network and his or her chances of getting help should a need arise. Below is a sample:
Name_______________________ Age__________________

Any disabilities or health condition that require social support (specify)


(Use Yes, Sometimes, Rarely, and Never to indicate the frequency of your social support actions)

Q1. Do you have friends or family members who care about what happens to you? _______

Q2. Do you get enough love and affection from your family and friends? _______

Q3. Do you get a chance to talk about your problems or concerns with a family member or a friend? _______

Q4. Can you trust any of your friends with any of your family problems? _______

Q5. Can you talk to your family or friends about financial matters or concerns? _______

Q6. Do you get invitations to attend dinner, lunch or social functions within your community? _______

Q7. Do you think your friends and family give you valuable advice regarding work, relationships or investments when you need it? _______

Q8. Do you help your family members and friends in situations where your input would do them good? _______