Feedback/Guidance - Employee Survey Sample #7

Questionnaires Measuring Feedback/Guidance:
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:
Feedback/Guidance, Job Content and Design, Innovation, Quality, Equipment, Career Development, Professionalism, Teamwork, Department, Employee Development

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:

Feedback/Guidance	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
I receive mentoring and coaching from my superior. (Click here to add a comment)
I am given clear instructions and objectives. (Click here to add a comment)
I do not feel micro-managed. (Click here to add a comment)
I actively seek feedback from colleagues and customers about my work. (Click here to add a comment)
I see my role to include mentoring and coaching others. (Click here to add a comment)
If [Participant Name] were to make improvements in Feedback/Guidance, 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 Content and Design	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
I am clear about the expectations of my role. (Click here to add a comment)
The job re-classification process is simple and efficient (Click here to add a comment)
I can make positive suggestions and improve how the Company operates (Click here to add a comment)
I can adjust my job description as needed (Click here to add a comment)
My job description accurately reflects what I do on a daily basis (Click here to add a comment)
If [Participant Name] were to make improvements in Job Content and Design, 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?

Innovation	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
Employees are rewarded for sharing their ideas and suggestions. (Click here to add a comment)
The Company supports innovative processes developed by employees (Click here to add a comment)
My ideas and suggestions are accepted and considered (Click here to add a comment)
People in My Department are very innovative (Click here to add a comment)
My Supervisor looks for new and better ways of doing things (Click here to add a comment)
If [Participant Name] were to make improvements in Innovation, 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?

Quality	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
Methods are in place to identify production problems (Click here to add a comment)
Managers try to prevent production problems before they occur (Click here to add a comment)
The people in my team are committed to doing quality work (Click here to add a comment)
My quality work instructions provide meaningful guidance on how to accurately perform my job duties. (Click here to add a comment)
Management places importance on quality work. (Click here to add a comment)
If [Participant Name] were to make improvements in Quality, 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
All employees in my department conduct pre- and post-trip assessments of the equipment (Click here to add a comment)
Employees in my department comply with safety protocols and procedures (Click here to add a comment)
I have the uniform, tools, and equipment I need to do my job (Click here to add a comment)
Our department has the right equipment for the job. (Click here to add a comment)
I perform routine inspection and preventative maintenance on assigned equipment (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?

Career Development	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
Employees are required to create their own Individual Development Plan. (Click here to add a comment)
My manager discusses my career path with me. (Click here to add a comment)
There is opportunity for me to advance at the Company (Click here to add a comment)
My supervisor works with me to develop my Individual Development Plan (Click here to add a comment)
I have the skills needed to advance my career. (Click here to add a comment)
If [Participant Name] were to make improvements in Career 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?

Professionalism	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
Customers receive professional service (Click here to add a comment)
Employees maintain an appropriate appearance (Click here to add a comment)
Employees pay attention to the speaker in meetings (Click here to add a comment)
Employees do not leave work early (Click here to add a comment)
Employees treat each other with courtesy and respect (Click here to add a comment)
If [Participant Name] were to make improvements in Professionalism, 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?

Teamwork	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
Employees in this Company work well together. (Click here to add a comment)
Teamwork is positively impacting our business results. (Click here to add a comment)
Other team members will help me if I need help (Click here to add a comment)
Our team fosters open communication (Click here to add a comment)
I have a good relationship with my co-workers. (Click here to add a comment)
If [Participant Name] were to make improvements in Teamwork, 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?

Department	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
I feel my department is very productive. (Click here to add a comment)
People in my department encourage new ideas to solve problems. (Click here to add a comment)
Employees in my department treat me with respect and dignity. (Click here to add a comment)
Employees communicate freely within our department. (Click here to add a comment)
My team focuses on fixing the problem rather than finding someone to blame. (Click here to add a comment)
If [Participant Name] were to make improvements in Department, 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
I am continuously learning and trying to improve myself (Click here to add a comment)
The Company is aware of our department's training needs. (Click here to add a comment)
I have access to continuous training opportunities (Click here to add a comment)
There are good opportunities for me to take classes in leadership to become a manager/supervisor (Click here to add a comment)
The Company offers regular workshops and seminars to help train employees (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?