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Questionnaire template

Employee Grievance Survey

Lets employees report workplace grievances about facilities, relationships, communication, mistreatment and harassment.

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Human Resources · Employee. All Human Resources templates

Questions in this template

Workplace Environment

  1. This survey gives you a confidential way to tell us about problems you face at work. What you share will help us make the workplace fairer and more comfortable.

  2. How often do you feel at ease in your workplace?

    Choose one:

    • Never
    • Rarely
    • Sometimes
    • Often
    • Always

  3. How would you rate each of these parts of your workplace?

    • Your own workspace (desk, office or room)
    • Lunch and break rooms
    • Restrooms
    • Parking and public transport access
    • General cleanliness

    For each row: choose one:

    • Very poor
    • Poor
    • Fair
    • Good
    • Excellent

Relationships at Work

  1. Do your coworkers treat you with respect?

    Choose one:

    • Yes
    • Sometimes
    • No

  2. How would you describe your relationship with your direct manager?

    Choose one:

    • Very poor
    • Poor
    • Neutral
    • Good
    • Very good

  3. What makes your relationship with your manager difficult?

    Condition: Asked when the relationship is rated poor

    Open answer

Communication

  1. Does each statement describe your experience?

    • I am kept up to date on news from my department.
    • I get clear instructions for my tasks.
    • I am told in advance about changes that affect my work.
    • My suggestions are listened to and considered.

    For each row: choose one:

    • Yes
    • Not sure
    • No

Your Concerns

  1. Which of these problems have you experienced at work? Select all that apply.

    Choose any that apply:

    • Excessive workload or overtime
    • Not enough breaks
    • Physical or verbal harassment
    • Discrimination
    • Safety hazards
    • None of these

  2. Please describe the problems you experienced.

    Condition: Asked when at least one problem is selected

    Open answer

  3. In the past 12 months, have you felt that you were treated unfairly at work?

    Choose one:

    • Yes
    • No

  4. Please describe what happened.

    Condition: Asked when unfair treatment is reported

    Open answer

  5. Was the matter resolved?

    Condition: Asked when unfair treatment is reported

    Choose one:

    • Yes, fully
    • Partly
    • No
    • I did not report it