Pulse Survey Master Form

  • 1. Please indicate your level of agreement with the following statements:

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  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • 2. Please indicate your level of agreement with the following statements:

  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • 3. Please indicate your level of agreement with the following statements: (Same 5 point scale)

    Considering all aspects of my job...
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
    I love working for this company
    I love my workplace
    I love my manager
    I love my co-workers
    I love my CEO
  • 4. The top 3 reasons I love working for this company are…

  • 5. The top 3 things that would make me love working for this company more are...

  • 6. How likely is it that you would recommend working at your company to a friend or colleague?

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    Please rate your opinion on scale 1-10
  • 7. About You

  • Below AverageAverageAbove AverageNot OfferedNot Applicable
    Paid time off such as PTO, sick days, and vacation days
    Health insurance
    Life insurance
    Dental insurance
    Vision insurance
    Paid Parental Leave for All
    Family Forming Fertility Benefits
    Gender Affirming Surgery and Related Leave
    Retirement benefits or accounts
    Healthcare spending or reimbursement accounts, such as HSAs, FSAs, and HRAs
    Long term disability insurance
    Short term disability insurance
    Tuition reimbursement
    Childcare benefits
    Gym memberships or discounts
    Wellness programs
    Employee recognition programs
    Relocation assistance
    Commuting/travel assistance
    Telecommuting options
    Workplace perks such as recreation activities, food and coffee, and flexible work schedules