Safety- Employee Opinion Survey Sample #11

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 [Company] Employee Survey. Our objective is to understand and express the values which will ensure [Company] is an exceptional place to work. We are asking you to take time to respond to this survey to help us identify where we are doing well and where we have opportunities to do better.

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.

Please be honest, constructive and thoughtful in your responses. The results of this survey will be used to help drive our future success. 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

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.


What does Safety mean?
It means that ...
  • Safety is a primary concern at the Company
  • Managers pay attention to workplace safety
  • Managers regularly meet with employees to discuss safety issues
  • My Supervisor would not ask me to perform an unsafe procedure
  • My work environment is safe

To what extent does our company exhibit Safety?
Select from one of the ratings below.


What does Meetings mean?
It means that ...
  • All employees are encouraged to share their input at meetings
  • Meetings are a useful way for employees to work together
  • I get important and useful information from meetings
  • The Company should offer training on how to improve meeting effectiveness
  • We make the best use of meetings and meetings are tailored to specific needs and purposes.

To what extent does our company exhibit Meetings?
Select from one of the ratings below.


What does Initiative mean?
It means that ...
  • My supervisor encourages initiative.
  • Leadership at the Company encourages initiative and risk taking
  • Senior Management at Company encourages initiative.
  • I feel encouraged to come up with new and better ways of doing things
  • The Company seeks to take advantage of opportunities

To what extent does our company exhibit Initiative?
Select from one of the ratings below.

Respect for Others

What does Respect for Others mean?
It means that ...
  • At this company, my suggestions are given serious consideration.
  • I feel I am valued at work.
  • Disrespectful behavior is not tolerated.
  • Co-workers respect each others' opinions
  • Individual differences are seen as strengths.

To what extent does our company exhibit Respect for Others?
Select from one of the ratings below.

Wellness Program

What does Wellness Program mean?
It means that ...
  • The wellness program is convenient for me
  • I feel confident in using the wellness program
  • I feel the wellness program is an excellent support resource for employees
  • The Company wellness program focuses on preventive care, quality of life, and employee satisfaction
  • The Company wellness program is personal and confidential

To what extent does our company exhibit Wellness Program?
Select from one of the ratings below.

On a scale of Excellent to Poor, how would you rate your overall employment with [Company] and why?

Would you refer others who are seeking employment to [Company]?

Please provide explanation:

If you had an opportunity to make any change you wanted to make [Company] a better place to work, what one improvement would you make?

What changes do you see [Company] making in order to raise the standards?

I feel good about my continued employment with [Company].

If no, please provide explanation:

What do you like best about working for [Company]?

What do you like least about working for [Company]? How could it be improved?

Use the space below to enter any final comments you would like to be noted: