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Safety - Employee Opinion Survey Sample #1





Surveys Measuring Safety:
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 Opinion Survey. We recognize that our employees are our biggest asset and we are committed to continuing to ensure that the [Company] is considered a great place to work. We would like to hear from you as your opinions will help to guide our objectives.

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.

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

Dimensions Included:
Safety, Communication, Feedback/Guidance, Job Satisfaction, Flexibility, Training, Leadership, Company, Resources, Wellness Program


Instructions:
Please complete the items below and press the submit button at the end of the survey. If you need multiple sessions to complete the survey, please click the "Submit" button at the end of each session to save your responses. Please feel free to skip any items that you do not wish to respond to. Keep in mind that your responses help us to become a better place to work. So, you are encouraged to respond to all items on the questionnaire.

Edit this Survey
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Safety

Strongly
Disagree
1
2
Neutral
3
4
Strongly
Agree
5
Not
Applicable
  1. My manager interviews employees and witnesses involved in an accident to understand the sequence of events.
  1. My manager identifies potential hazards before they lead to incidents and takes steps to eliminate or control them.
  1. The company builds workforce capability by developing employees' technical safety skills.
  1. Managers recognize teams or individuals who contribute to hazard reduction.
  1. Leaders collaborate with facilities, maintenance, or engineering teams to address environmental safety concerns.
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?

Communication

Strongly
Disagree
1
2
Neutral
3
4
Strongly
Agree
5
Not
Applicable
  1. My Supervisor does a good job sharing information with me
  1. Sales reps set their on-line status to "available" to indicate they are available for communication.
  1. I am comfortable clarifying problems logically, simplifying complex matters into digestible parts
  1. I know how to effectively use non-verbal communication (e.g., eye contact, nodding, gestures, etc.)
  1. My manager uses ideas and perspectives to persuade others
If [Participant Name] were to make improvements in Communication, 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?

Feedback/Guidance

Strongly
Disagree
1
2
Neutral
3
4
Strongly
Agree
5
Not
Applicable
  1. I see my role to include mentoring and coaching others.
  1. I actively seek feedback from colleagues and customers about my work.
  1. I receive mentoring and coaching from my superior.
  1. I do not feel micro-managed.
  1. I am comfortable giving feedback to others.
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 Satisfaction

Strongly
Disagree
1
2
Neutral
3
4
Strongly
Agree
5
Not
Applicable
  1. It is important to me to feel appreciated at work.
  1. I like my work
  1. I feel a strong commitment to my job and the schedule I work.
  1. I feel the company is being run by good managers.
  1. I have flexibility in managing my time and prioritizing tasks.
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?

Flexibility

Strongly
Disagree
1
2
Neutral
3
4
Strongly
Agree
5
Not
Applicable
  1. My manager adapts strategies to fit the specific needs of each situation.
  1. My manager actively seeks out new knowledge, staying updated with industry trends, and is open to changing the workflow based on the situation.
  1. I am permitted to introduce new products or services.
  1. My coworkers possess a high degree of flexibility to meet the challenges posed by unforeseen circumstances.
  1. The supervisor changes their approach in response to new information.
If [Participant Name] were to make improvements in Flexibility, 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
1
2
Neutral
3
4
Strongly
Agree
5
Not
Applicable
  1. The trainers used are knowledgeable and effective
  1. The Company employs competent and skilled trainers
  1. Training opportunities are available to everyone
  1. The on-the-job training I received has prepared me for this job
  1. Training is offered to improve performance.
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?

Leadership

Strongly
Disagree
1
2
Neutral
3
4
Strongly
Agree
5
Not
Applicable
  1. My department provides a moral standard of ethical and honest work.
  1. Supervisors use influence to shift team behavior gradually, reinforcing desired outcomes through recognition and feedback.Ó
  1. Managers expect continuous learning, skill-building, and professional growth from employees.
  1. Our manager removes performance barriers by providing necessary systems, information, tools, and resources people need to do their jobs and develop.
  1. My manager is able to influence others.
If [Participant Name] were to make improvements in Leadership, 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
1
2
Neutral
3
4
Strongly
Agree
5
Not
Applicable
  1. I feel energized by the challenges we tackle.
  1. This company cares about its people--and it shows.
  1. Our department is adequately staffed.
  1. The parking area is well maintained.
  1. There's mutual respect across roles and departments at the Company.
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?

Resources

Strongly
Disagree
1
2
Neutral
3
4
Strongly
Agree
5
Not
Applicable
  1. I understand the budget process
  1. My workplace is a physically comfortable place to work
  1. The Company has the right people in the right places.
  1. I can manage information and technical resources to achieve objectives
  1. My Supervisor is effective in maximizing the potential of others
If [Participant Name] were to make improvements in 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?

Wellness Program

Strongly
Disagree
1
2
Neutral
3
4
Strongly
Agree
5
Not
Applicable
  1. The Company wellness program is easy to use
  1. I would encourage others to use the wellness program
  1. The Company wellness program is personal and confidential
  1. The wellness program provides a wide array of services to meet my needs
  1. I feel confident in using the wellness program
If [Participant Name] were to make improvements in Wellness 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?




  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: