Diversity - Employee Engagement Survey Sample #3

Questionnaires Measuring Diversity:
Example 1 (5-point scale; numbers; NA)
Example 2 (7-point scale; radio buttons)
Example 3 (4-point scale; radio buttons)
Example 4 (5-point scale; radio buttons)
Example 5 (5-point scale; words)
Example 6 (Pulse Survey)
Example 7 (5-point scale; item comments)
Example 8 (3-point scale; words; N/A)
Example 9 (4-point scale; numbers)
Example 10 (Comment boxes only)
Example 11 (Single rating per dimension)
Example 12 (Slide-bar scale)
Dear Employee:

Welcome to the Employee Engagement Survey. We are on a journey to create a workplace that encourages success! A critical component of creating this culture is building a business you recognize as being a great place to work and one that provides you with challenge and recognition. We want to build a thriving and successful business that provides motivation and satisfaction. In order to do so we need to assess how we are doing and understand your thoughts, views and feelings.

We have developed this survey with questions tailored for our staff and business to provide you with an opportunity to anonymously rate many facets of the business. The survey will assess what you value most in your employment and allow you to make positive suggestions for improvement.

This survey will take approximately 15-20 minutes to complete. We valued your feedback last year and once again, we encourage you to be honest and constructive in your responses. Should you need to leave your survey before it is complete, you can access it again simply by clicking on the link provided in the introductory email you received. Please do not forward your survey link to any other email address.

Please ensure that your submission is made between . The survey will only be available during these dates.

Thank you for your participation in the survey. We look forward to seeing the analysis of your responses and we are hoping for 100% participation.

Management Team


  1. Employees of all backgrounds are highly productive in our company.
  1. Employees of all genders have an equal opportunity for promotions.
  1. This company values the differences that exist between individuals
  1. A more diverse workforce would improve the company's bottom line
  1. I have the same opportunity to succeed as others with similar education and experience.


  1. My Supervisor would not ask me to perform an unsafe procedure
  1. The safety and health conditions where I work are good
  1. I know what to do in an emergency situation
  1. Managers regularly meet with employees to discuss safety issues
  1. Managers pay attention to workplace safety

Career Development

  1. At work, I have opportunities to learn and grow
  1. My manager discusses my career path with me.
  1. Job promotions are awarded fairly and without bias
  1. Employees are required to create their own Individual Development Plan.
  1. There is opportunity for me to advance at the Company


  1. I am given clear instructions and objectives.
  1. I trust the feedback I receive from My Supervisor
  1. I have a good relationship with my supervisor.
  1. My Supervisor communicates the actions necessary for me to take to achieve organizational objectives
  1. I am treated fairly by My Supervisor.

Information Technology/IT

  1. IT Staff are good at troubleshooting issues to get to the root cause of the problem.
  1. IT Department staff usually have the answers when I need help.
  1. The IT Department is effective in maintaining the equipment in my department.
  1. The IT Department knows how to repair the equipment in our department.
  1. IT staff are knowledgeable about the software and equipment we use.

  1. What changes would you like to see in your benefit plans? Please note that some of these may increase premium rates. Please check all that apply.
    Add a higher deductible plan ($1,000 - $2,500)
    Increase vision care
    Increase dental care
    Add wellness program (weight loss, nutrition, smoking cessation programs, etc.)
    Add a Medical Spending Account (MSA) (allows employees to enroll in a high deductible health plan,
    spacer and then [Company] and the employee contribute on a pre-tax basis to an account used for eligible medical expenses)

  2. What changes would you be willing to accept in order to help hold down premium increases? Please check all that apply.
    Higher annual deductibles (the amount you pay out-of-pocket before benefits begin)
    Higher office visit co pays (the dollar amount you pay for office visits)
    Higher prescription drug co pays (the dollar amount you pay for prescription drugs)
    More network restrictions (smaller group of doctors and specialists to choose from)
    No dental coverage
    Other, please specify

  3. How often would you like to participate in after hours company event?

  4. How would you rate your satisfaction with the communication between you and [Company]?

  5. What would you change about your current job or position?

  6. Please identify factors that would improve your job performance in the coming year.

  7. When your performance was discussed with you in the past,
    how often did you receive practical suggestions for improving your work?

  8. How would you rate your overall satisfaction with the company in the past year?

  9. Please give any comments or suggestions on how the company can be improved in the coming year: