Performance Appraisal/Management - Pulse Survey - Sample #7

Questionnaires Measuring Performance Appraisal:
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:
Performance Appraisal/Management, Career Development, Pride/Loyalty, Supervisor, Human Resources, Turnover, Employee Relations, Facilities

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:

Performance Appraisal/Management	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
I am clear about what is expected of me in my position as a result of the Performance Process (Click here to add a comment)
The Performance Appraisal system has specific standards (Click here to add a comment)
My Supervisor is honest and fair in my performance review (Click here to add a comment)
Pay raises are linked to performance evaluations (Click here to add a comment)
The Performance Management process is effective. (Click here to add a comment)
If [Participant Name] were to make improvements in Performance Appraisal/Management, 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
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)
My Supervisor has taken an interest in my career development (Click here to add a comment)
Job promotions are awarded fairly and without bias (Click here to add a comment)
At work, I have opportunities to learn and grow (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?

Pride/Loyalty	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
I feel like I am able to help my department. (Click here to add a comment)
This organization actively contributes to the community. (Click here to add a comment)
This is the best place I have ever worked. (Click here to add a comment)
I am glad I chose to work at this Company. (Click here to add a comment)
I am glad to be working in my department. (Click here to add a comment)
If [Participant Name] were to make improvements in Pride/Loyalty, 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?

Supervisor	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
My Supervisor supports team members who are working on difficult projects (Click here to add a comment)
My Supervisor provides useful and constructive feedback to employees (Click here to add a comment)
My Supervisor motivates and inspires high performance by team members (Click here to add a comment)
My Supervisor has high technical skills (Click here to add a comment)
My Supervisor is aware of the unique strengths of each employee (Click here to add a comment)
If [Participant Name] were to make improvements in Supervisor, 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
The HR department has communicated benefit updates and changes regularly and clearly. (Click here to add a comment)
The Human Resources staff is accessible and responsive when I need assistance. (Click here to add a comment)
Human Resources cooperates and works together with all departments to effectively achieve the Company's objectives. (Click here to add a comment)
Information from Human Resources is informative, relevant/timely and consistent. (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?

Turnover	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
I would describe my department as non-productive (Click here to add a comment)
My current work environment is hostile (Click here to add a comment)
There is a lack of opportunities in the company (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?

Employee Relations	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
Managers work to obtain win-win resolutions (Click here to add a comment)
The Company holds quarterly and annual gatherings to keep everyone up-to-date (Click here to add a comment)
My Supervisor is not afraid to take disciplinary action when needed (Click here to add a comment)
Employees are able to work independently when necessary (Click here to add a comment)
The administrative policies are implemented fairly across the organization (Click here to add a comment)
If [Participant Name] were to make improvements in Employee Relations, 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?

Facilities	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
The Facilities department is responsive when I make requests to fixing equipment and/or office space (Click here to add a comment)
I have easy access to the different offices and meeting rooms (Click here to add a comment)
The Facilities department responses to my requests (Click here to add a comment)
The building I work in is well maintained (Click here to add a comment)
I am aware of the procedures I need to take to evacuate the building in case of a fire or natural disaster (Click here to add a comment)
If [Participant Name] were to make improvements in Facilities, 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?