Work Life Balance Survey
Name
First Name
Last Name
Job Title
Age
Marital Status
Married
Single
Seperated
Widowed
Divorced
Prefer not to say
Other
Do you have any dependents living with you?
Yes
No
How many dependents?
How long have you worked here?
0-1 year
2-4 years
5-8 years
9-12 years
12-15 years
More than 15 years
In a week, how many hours on average do you work?
Less than 20 hours
20-30 hours
30-40 hours
More than 40 hours
Please rate how strongly you agree or disagree with each of the statements related to your job.
Rows
Totally Disagree
Somewhat Disagree
Neutral
Somewhat Agree
Totally Agree
N/A
My happiness totally depend on my job.
1
2
3
4
5
6
My happiness depend on my salary.
7
8
9
10
11
12
My family is the most important factor for my happiness.
13
14
15
16
17
18
My job very satisfies me.
19
20
21
22
23
24
I find my job enjoyable.
25
26
27
28
29
30
My job's effects on my happiness is positive.
31
32
33
34
35
36
My co-workers positively contribute my working environment.
37
38
39
40
41
42
My supervisors positively contribute my working environment.
43
44
45
46
47
48
My work schedule allow me to spend time with my family and friens.
49
50
51
52
53
54
How do you find your current work-life balance?
Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
Please rate how satisfied are you with the followings.
Rows
Not Satisfied
Somewhat Satisfied
Neutral
Satisfied
Very Satisfied
N/A
Time spend with my family
55
56
57
58
59
60
My home life
61
62
63
64
65
66
Time I connect with my family and/or friends.
67
68
69
70
71
72
Please sort the list according to your prioritization.
Please rate how strongly you agree or disagree with each of the statements related to your job.
Rows
Totally Disagree
Somewhat Disagree
Neutral
Somewhat Agree
Totally Agree
N/A
I feel overwhelmed by my workload.
73
74
75
76
77
78
I feel there isn't enough time in a week.
79
80
81
82
83
84
I usually sacrifice sleep for work.
85
86
87
88
89
90
I always leave work at work.
91
92
93
94
95
96
I leave work everyday at generally same time.
97
98
99
100
101
102
I don't plan to change my company for the foreseeable future.
103
104
105
106
107
108
Do you have any thoughts to improve your work-life balance
Submit
Should be Empty: