Workplace Satisfaction Survey
Employee Name
First Name
Last Name
Birth Date
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Department
E-mail
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
1) How long have you been working?
0-1 year
1-5 years
5-10 years
Other
2) Which factor is important for you in workplace?
Respect
Trust
Pay and Benefits
Career Path
Healthy Environment
Security
Other
3) Do you find your work meaningful?
Yes
No
4) On a scale of 1-10, can you rate your company culture?
1
2
3
4
5
6
7
8
9
10
5) Are you satisfied with your workplace?
Rows
Not Satisfied
Somewhat Satisfied
Satisfied
Very Satisfied
Management
1
2
3
4
Working Hours
5
6
7
8
Amount of
9
10
11
12
Salary
13
14
15
16
Instructor Knowledge
17
18
19
20
Activities
21
22
23
24
Medical Benefits
25
26
27
28
Working Environment
29
30
31
32
Life Balance
33
34
35
36
6) How happy are you with the workplace?
Not
1
2
3
4
5
6
7
8
9
Very
10
1 is Not, 10 is Very
7) What would be the excuse, hypothetically, if you were to leave tomorrow?
8) Is your team a source of motivation for you to perform at your best?
Yes
No
9) Please leave any feedback or suggestions to create better workplace.
Submit
Should be Empty: