Work/Life - Employee Survey Sample #7

Questionnaires Measuring Work/Life:
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:
Work/Life, Quality, Systems, Training, Stress, Business Focus, Hiring, Resources, Pay

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:

Work/Life	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
My Supervisor would let me leave work early if I needed to. (Click here to add a comment)
My work schedule is flexible enough to meet my needs (Click here to add a comment)
The Company offers me the flexibility I want in allowing me to work at home or change my hours, when required (Click here to add a comment)
I can alter my work schedule to suit my needs. (Click here to add a comment)
The Company helps employees find an ideal balance between work and life responsibilities (Click here to add a comment)
If [Participant Name] were to make improvements in Work/Life, 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?

Quality	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
Continuous learning and improvement helps the Company respond to Change and achieve success (Click here to add a comment)
My quality work instructions provide meaningful guidance on how to accurately perform my job duties. (Click here to add a comment)
The people in my team are committed to doing quality work (Click here to add a comment)
Methods are in place to identify production problems (Click here to add a comment)
The Company's image is that of a high quality Employer. (Click here to add a comment)
If [Participant Name] were to make improvements in Quality, 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?

Systems	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
Managers are skilled and trained in the various systems to help employees when needed (Click here to add a comment)
The Quality Management system in place helps us achieve compliance with ISO 9001 and other models for quality systems (Click here to add a comment)
Training is implemented as a coordinated part of an overall system of employee development (Click here to add a comment)
The Company uses a systematic process for identifying employee development needs and implementing solutions (Click here to add a comment)
Continuity of leadership is achieved through effective succession planning (Click here to add a comment)
If [Participant Name] were to make improvements in Systems, 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	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
I have received good training to do my job (Click here to add a comment)
I feel I am well prepared and have the tools to succeed in my role as an associate, supervisor, manager, or top leader. (Click here to add a comment)
The on-the-job training I received has prepared me for this job (Click here to add a comment)
The training I receive is relevant to my job (Click here to add a comment)
I am allowed to take initiative to assess my skills and seek appropriate training (Click here to add a comment)
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?

Stress	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
I feel safe in my job (Click here to add a comment)
I do not fear losing my job (Click here to add a comment)
I rarely experience stress here (Click here to add a comment)
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)
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?

Business Focus	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
The Company engages in various initiatives to focus on its business strategy (Click here to add a comment)
Strategic planning helps develop new business opportunities (Click here to add a comment)
The Leadership is effective in allocating financial resources (Click here to add a comment)
The Company continues to grow and expand its services (Click here to add a comment)
The Company seeks to take advantage of opportunities (Click here to add a comment)
If [Participant Name] were to make improvements in Business Focus, 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?

Hiring	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
Managers follow the hiring procedures (Click here to add a comment)
The Company has a good pool of applicants to choose from (Click here to add a comment)
The hiring process is efficient and easy to follow (Click here to add a comment)
The Company is good at finding the right talent for current and future work. (Click here to add a comment)
Hiring procedures are clearly defined (Click here to add a comment)
If [Participant Name] were to make improvements in Hiring, 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	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
I have all the tools and equipment I need to do my job well (Click here to add a comment)
I understand the budget process (Click here to add a comment)
My workplace is a physically comfortable place to work (Click here to add a comment)
My workplace is well maintained and safe (Click here to add a comment)
I can manage information and technical resources to achieve objectives (Click here to add a comment)
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?

Pay	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
The pay offered by the Company is very competitive (Click here to add a comment)
My Supervisor is always trying to make sure I am fairly compensated (Click here to add a comment)
I am satisfied with the level of pay I receive (Click here to add a comment)
I feel I am adequately paid compared to my colleagues at other companies (Click here to add a comment)
I am paid fairly (Click here to add a comment)
If [Participant Name] were to make improvements in Pay, 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?