Coronavirus Return-to-Work Survey
Please fill out the form questions below to improve our work environment and ease our back to work transition process.
How do you feel about returning to work in the office?
Very Uncomfortable
1
2
3
4
5
6
7
8
9
Very Comfortable
10
1 is Very Uncomfortable, 10 is Very Comfortable
How would you rate your productivity level while working from home compared to work in the office?
Less Productive
1
2
3
4
5
6
7
8
9
Much Productive
10
1 is Less Productive, 10 is Much Productive
Please rate your confidence level on the following statements below:
Strongly Disagree
Slightly Disagree
Agree
Strongly Agree
I understand the recently updated organizational health and safety policies and procedures that have been put in place.
1
2
3
4
As we prepare to return to work, I feel confident that I will be able to attend to my personal responsibilities (e.g., child care and eldercare).
5
6
7
8
I'm confident that my organization will take appropriate measures to keep me as safe as possible when we return to work.
9
10
11
12
I am comfortable traveling for work if required.
13
14
15
16
I am comfortable commuting via public transit to work.
17
18
19
20
I feel a sense of control over when I return to work.
21
22
23
24
Would you prefer to work from home if that option is extended?
Yes
No
Do you have any of the following concerns about going back to work in the office?
Less productivity
Decreased flexibility
Exposure to coronavirus
Fear of spreading coronavirus
Sustaining child care/eldercare
Household members who need assistance
Not being able to return to the office due to health conditions
Other
Will you have personal issues that require special treatment upon returning to work?
Any additional ideas, comments and concerns:
Submit
Should be Empty: