Employee Assistance - Employee Survey Sample #7

Questionnaires Measuring Employee Assistance:
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 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.

The survey is web-based, quick and simple to complete which allows fast reporting and analysis. To ensure your anonymity, the survey is being hosted by an external organization. You will not be required to identify yourself. We want to be very clear that we will not be able to attribute this data to any specific individual and it is not our intention to do so.

Dimensions Included:
Employee Assistance Program, Employee Development, Human Resources, Job Satisfaction, Equipment, Change, Training, Respect for Others, Corporate Culture, Turnover

We encourage everyone to complete the survey. Please be honest, constructive and thoughtful in your input. The survey is designed to help us understand more about your thoughts and needs to make this a great company.

The results of this survey will be used to help drive our future success. We will report back to you about what you have said and what we plan to do about it. If you have any questions about the process please contact [Contact Person].

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

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,

and then [Company] and the employee contribute on a pre-tax basis to an account used for eligible medical expenses)

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

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

Every other month
Quarterly
Twice a year
Just the Christmas Party
How would you rate your satisfaction with the communication between you and [Company]?

Very Dissatisfied
Dissatisfied
No Opinion
Satisfied
Very Satisfied
What would you change about your current job or position?
Please identify factors that would improve your job performance in the coming year.
When your performance was discussed with you in the past,
how often did you receive practical suggestions for improving your work?

Very Often
Sometimes
Rarely
Never
How would you rate your overall satisfaction with the company in the past year?

Very Dissatisfied
Dissatisfied
No Opinion
Satisfied
Very Satisfied
Please give any comments or suggestions on how the company can be improved in the coming year:

Employee Assistance Program	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
EAP practitioners are flexible in scheduling appointments. (Click here to add a comment)
The EAP used by the Company meets the established standards for service. (Click here to add a comment)
I feel the EAP provides confidential services. (Click here to add a comment)
The Company EAP is confidential (Click here to add a comment)
The EAP used provides confidential counseling services to both the employee and family members. (Click here to add a comment)
If [Participant Name] were to make improvements in Employee Assistance Program, which item do you think should be emphasized most over the next two years in order to make us a more effective organization.
Type the number here:
What are your suggestions for how we can improve this?

Employee Development	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
The Company offers regular workshops and seminars to help train employees (Click here to add a comment)
The corporate culture at our company supports employee growth and development. (Click here to add a comment)
Employees are encouraged to seek professional development (Click here to add a comment)
Training is offered on critical applications and equipment when needed (Click here to add a comment)
I am satisfied with the current training opportunities (Click here to add a comment)
If [Participant Name] were to make improvements in Employee Development, which item do you think should be emphasized most over the next two years in order to make us a more effective organization.
Type the number here:
What are your suggestions for how we can improve this?

Human Resources	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
CompanyName has adequate HR staff and resources to meet the company's needs. (Click here to add a comment)
Human Resources treats all employees with courtesy and respect. (Click here to add a comment)
The HR department has communicated benefit updates and changes regularly and clearly. (Click here to add a comment)
I have confidence in the HR department to resolve payroll and benefit issues. (Click here to add a comment)
The HR department handles questions and issues fairly. (Click here to add a comment)
If [Participant Name] were to make improvements in Human Resources, which item do you think should be emphasized most over the next two years in order to make us a more effective organization.
Type the number here:
What are your suggestions for how we can improve this?

Job Satisfaction	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
I feel satisfied at the Company (Click here to add a comment)
Considering everything, I am satisfied at this Company (Click here to add a comment)
The people in my department feel good about coming to work (Click here to add a comment)
I receive a lot of satisfaction from my job (Click here to add a comment)
My job is rewarding (Click here to add a comment)
If [Participant Name] were to make improvements in Job Satisfaction, which item do you think should be emphasized most over the next two years in order to make us a more effective organization.
Type the number here:
What are your suggestions for how we can improve this?

Equipment	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
Employees in my department regularly check and maintain equipment (Click here to add a comment)
Our department maintains a log of preventative maintenance performed (Click here to add a comment)
I have knowledge of proper safety protocols (Click here to add a comment)
My Supervisor is aware of the safety procedures needed to operate the equipment (Click here to add a comment)
I am easily able to order more supplies for the equipment as needed (Click here to add a comment)
If [Participant Name] were to make improvements in Equipment, which item do you think should be emphasized most over the next two years in order to make us a more effective organization.
Type the number here:
What are your suggestions for how we can improve this?

Change	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
The Leadership involves employees when making significant changes (Click here to add a comment)
Management is able to implement a vision and mission (Click here to add a comment)
Managers are effective in addressing resistance to change (Click here to add a comment)
The Leadership keeps a focus on where the Company needs to go (Click here to add a comment)
The Company is pro-active in implementing changes to address challenges and opportunities (Click here to add a comment)
If [Participant Name] were to make improvements in Change, which item do you think should be emphasized most over the next two years in order to make us a more effective organization.
Type the number here:
What are your suggestions for how we can improve this?

Training	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
The Company employs competent and skilled trainers (Click here to add a comment)
Training is offered at times convenient to me (Click here to add a comment)
The training I receive is relevant to my job (Click here to add a comment)
The on-the-job training I received has prepared me for this job (Click here to add a comment)
I feel I am well prepared and have the tools to succeed in my role as an associate, supervisor, manager, or top leader. (Click here to add a comment)
If [Participant Name] were to make improvements in Training, which item do you think should be emphasized most over the next two years in order to make us a more effective organization.
Type the number here:
What are your suggestions for how we can improve this?

Respect for Others	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
Individual differences are seen as strengths. (Click here to add a comment)
I feel I am valued at work. (Click here to add a comment)
At this company, my suggestions are given serious consideration. (Click here to add a comment)
Co-workers treat each other with respect (Click here to add a comment)
I feel respected by management in this organization. (Click here to add a comment)
If [Participant Name] were to make improvements in Respect for Others, which item do you think should be emphasized most over the next two years in order to make us a more effective organization.
Type the number here:
What are your suggestions for how we can improve this?

Corporate Culture	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
The Company is a good community neighbor (Click here to add a comment)
People enjoy working for the Company (Click here to add a comment)
Employees are generally friendly and willing to help you if needed (Click here to add a comment)
The Company new employee orientation includes information about our culture (Click here to add a comment)
CompanyName has an image of a high quality company. (Click here to add a comment)
If [Participant Name] were to make improvements in Corporate Culture, which item do you think should be emphasized most over the next two years in order to make us a more effective organization.
Type the number here:
What are your suggestions for how we can improve this?

Turnover	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
The level of benefits offered by the Company helps to reduce turnover (Click here to add a comment)
Employees enjoy working at the Company (Click here to add a comment)
The level of pay offered by the Company helps to reduce turnover (Click here to add a comment)
The benefits package provided by CompanyName helps reduce turnover. (Click here to add a comment)
Our department is able to attract and retain excellent employees (Click here to add a comment)
If [Participant Name] were to make improvements in Turnover, which item do you think should be emphasized most over the next two years in order to make us a more effective organization.
Type the number here:
What are your suggestions for how we can improve this?