Respect for Others - Employee Survey Sample #7

Surveys Measuring Respect for Others:
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:
Respect for Others, Decision Making, Company, Performance, Job Satisfaction, Safety, Equipment, Benefits, Staffing, Stress

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:

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)
I am treated with respect by others with whom I work. (Click here to add a comment)
Co-workers treat each other with respect (Click here to add a comment)
Co-workers respect each others' opinions (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?

Decision Making	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
My team makes decisions based on data (Click here to add a comment)
My manager can make quick decisions. (Click here to add a comment)
When deciding on something important, my manager understands the issues, problems, and potential solutions (Click here to add a comment)
My manager gathers information before making a decision (Click here to add a comment)
Our department anticipates needs for action. (Click here to add a comment)
If [Participant Name] were to make improvements in Decision Making, 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?

Company	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
This company is innovative in developing new ways to serve our customers. (Click here to add a comment)
Morale at CompanyName is high. (Click here to add a comment)
CompanyName is an ethical company. (Click here to add a comment)
Our standards for business ethics are high. (Click here to add a comment)
CompanyName has the right people in the right places. (Click here to add a comment)
If [Participant Name] were to make improvements in Company, 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?

Performance	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
I get a sense of personal accomplishment from my work (Click here to add a comment)
Performance measures are evaluated on a quarterly basis (Click here to add a comment)
My annual review is effective in identifying specific goals for performance improvement. (Click here to add a comment)
The Company is able to maximize employee potential (Click here to add a comment)
I am held accountable for achieving specific results (Click here to add a comment)
If [Participant Name] were to make improvements in Performance, 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
My job is rewarding (Click here to add a comment)
I feel satisfied at the Company (Click here to add a comment)
I enjoy working at the Company (Click here to add a comment)
Considering everything, I am satisfied at this Company (Click here to add a comment)
I receive a lot of satisfaction from my job (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?

Safety	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
The safety and health conditions where I work are good (Click here to add a comment)
My Supervisor would not ask me to perform an unsafe procedure (Click here to add a comment)
I know what to do in an emergency situation (Click here to add a comment)
Safety is a primary concern at the Company (Click here to add a comment)
My manager does not compromise on safety (Click here to add a comment)
If [Participant Name] were to make improvements in Safety, 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
I regularly perform minor maintenance procedures to prevent major issues from developing (Click here to add a comment)
I know how to perform preventative maintenance on the equipment (Click here to add a comment)
Employees in my department follow instructions well (Click here to add a comment)
My supervisor is aware of the routine inspection and preventative maintenance required (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?

Benefits	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
The Company offers better benefits than other companies (Click here to add a comment)
The benefits program meets my needs. (Click here to add a comment)
I recognize my benefits are part of an employee total compensation program (Click here to add a comment)
The premiums for benefits are reasonable (Click here to add a comment)
I think the benefits offered by the Company meet my needs (Click here to add a comment)
If [Participant Name] were to make improvements in Benefits, 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?

Staffing	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
CompanyName has the right people in the right places. (Click here to add a comment)
My Supervisor is good at building a staff of creative and innovative individuals (Click here to add a comment)
The Company has adequate help during peak work loads (Click here to add a comment)
My Department has the right people in the right places (Click here to add a comment)
My Department has an adequate level of staffing (Click here to add a comment)
If [Participant Name] were to make improvements in Staffing, 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?

Stress	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
I can change how I work if I want to (Click here to add a comment)
I have a relaxed and positive outlook (Click here to add a comment)
I rarely experience stress here (Click here to add a comment)
I participate in decisions that affect me (Click here to add a comment)
I do not fear losing my job (Click here to add a comment)
If [Participant Name] were to make improvements in Stress, 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?