Safety - Employee Opinion Survey Sample #3

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)
Dear Employee:

Welcome to the Employee Satisfaction 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.

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 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 and . 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


Agree Disagree Strongly
  1. Managers regularly meet with employees to discuss safety issues
  1. My manager does not compromise on safety
  1. My work environment is safe
  1. My Supervisor would not ask me to perform an unsafe procedure
  1. I know what to do in an emergency situation


Agree Disagree Strongly
  1. Decisions are clear and are communicated effectively organization-wide.
  1. Information and knowledge are freely shared at the Company
  1. I can speak freely to my supervisor on a variety of topics
  1. CompanyName does a good job communicating business objectives.
  1. I know what is expected of me at work


Agree Disagree Strongly
  1. I am given clear instructions and objectives.
  1. I actively seek feedback from colleagues and customers about my work.
  1. I am comfortable giving feedback to others.
  1. I receive adequate feedback and guidance.
  1. I receive mentoring and coaching from my superior.


Agree Disagree Strongly
  1. The Company uses a systematic process for identifying employee development needs and implementing solutions
  1. The Quality Management system in place helps us achieve compliance with ISO 9001 and other models for quality systems
  1. The Company has an excellent employee hiring and selection system
  1. Continuity of leadership is achieved through effective succession planning
  1. Training is implemented as a coordinated part of an overall system of employee development


Agree Disagree Strongly
  1. My Supervisor capitalizes on opportunities to grow the business
  1. Leadership at the Company encourages initiative and risk taking
  1. Senior Management at Company encourages initiative.
  1. The Company seeks to take advantage of opportunities
  1. I am allowed to take initiative to assess my skills and seek appropriate training


Agree Disagree Strongly
  1. Employees in my department are committed to the Company and want to remain here
  1. I would recommend the Company as a great place to work
  1. I am fully committed to a long-term career with CompanyName.
  1. My co-workers are committed to the success of the Company
  1. Employees in my department enjoy working together


Agree Disagree Strongly
  1. I am glad I chose to work at this Company.
  1. The Company is a good employer to work for.
  1. I feel this is a good place to work.
  1. This is the best place I have ever worked.
  1. I feel like I am able to help my department.


Agree Disagree Strongly
  1. My department is well managed.
  1. Communication is good between departments.
  1. My team looks for ways to change processes to improve performance.
  1. My team focuses on fixing the problem rather than finding someone to blame.
  1. Conditions in my work area allow me to be highly productive.


Agree Disagree Strongly
  1. The benefits package provided by CompanyName helps reduce turnover.
  1. Management helps reduce turnover.
  1. Employees enjoy working at the Company
  1. I plan to be working at the Company forever
  1. The level of pay offered by the Company helps to reduce turnover


Agree Disagree Strongly
  1. The HR Department helps in handling issues related to diversity
  1. Company offers financial support for diversity programs
  1. I rarely hear language/communication at work that I consider offensive or discriminatory.
  1. Managers in the company genuinely support equal opportunity for women
  1. This company values the differences that exist between individuals

  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,
    and then 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 ?

  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: