Workplace Productivity Health Awareness Survey Form
Share your workplace productivity habits and general health awareness so we can understand how work conditions and routines affect daily performance. The form uses the exact same title throughout.
Respondent Profile
Full Name
*
First Name
Last Name
Work Email
*
example@example.com
Department / Team
*
Job Role
*
Workday Productivity Patterns
Primary Work Arrangement
*
Onsite
Hybrid
Remote
Typical Focus Hours per Day
*
Please Select
0–2 hours
3–4 hours
5–6 hours
7–8 hours
9+ hours
Overall Productivity Over the Past Month
*
1
2
3
4
5
Health and Wellbeing Awareness
How aware are you of the following healthy work habits during your workday?
*
Rows
Not aware
Slightly aware
Moderately aware
Very aware
Always aware
Taking breaks
1
2
3
4
5
Drinking water regularly
6
7
8
9
10
Maintaining good posture
11
12
13
14
15
Moving around during the day
16
17
18
19
20
Which healthy work habits do you practice regularly?
Taking breaks
Drinking water regularly
Maintaining good posture
Moving around during the day
Other
Submit Survey
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