Jennie Bennett brought this to our attention, as the 5th Ward (Laurie Reeve's presidency) has distributed a similar survey (via their RS email list - great idea!) to their sisters. Using email doesn't capture everyone, but it is an increasingly efficient way to communicate (and save paper)
For a "sample" survey (that I tinkered around with for fun) - click on the link at the right column... or HERE.
It is easy to use this service (surveymonkey.com) to formulate your own survey at no charge...
What a great time of year to survey your sisters and turn over a new leaf (so-to-speak!).
With the new directives from our RS General Board - we are counseled to receive inspiration as a RS presidency, working together with the Priesthood (our good Bishops).
There are countless ways to get input from your sisters (surveys, visiting teachers, personal conversations, utilizing your meeting "committee", etc...)
Once you have this feedback, it's time to "go to our knees, go to the temple, and go to the Lord" - as Sister Beck has advised us.