Name:

Team Name:
Date & Time:

1. Organization:
• The company cares about my happiness and growth, which makes me more motivated
and satisfied at work. (
 Strongly Disagree
 Disagree
 Agree
 Strongly Agree
• The company has policies & rules that are fair, clear, and good for my well-being.
 Strongly Disagree
 Disagree
 Agree
 Strongly Agree
2. Leadership:
• The leaders tell us clearly what the company wants to achieve, which helps us know
where we're going.
 Not at all
 To a small extent
 To a moderate extent (Fair/ Descent)
 To a large extent
• Leaders are kind, listen to us, and fix problems quickly, which makes us trust them
more.
 Not at all
 To a small extent
 To a moderate extent (Fair/ Descent)
 To a large extent
3. Peers:
• My peers work together and help each other
 Not at all
 Very Rarely
 Sometimes
 Frequently
• My peers appreciate my work and I feel valued and motivated.
 Not at all
 Very Rarely
 Sometimes
 Frequently
4. Reporting Managers:
• My reporting manager gives me good advice, helps me do better, and supports me.
 Not at all
 Very Rarely
 Sometimes
 Frequently
• My reporting manager lets me do my work my way, encourages new ideas, and values
what I do.
 Not at all
 Very Rarely
 Sometimes
 Frequently
5. Self: (Intrisinc)
• I feel positive about my work and how it helps the company.
 Not at all
 Very Rarely
 Sometimes
 Frequently
• I am happy about what I have achieved and how I've grown here.
 Not at all happy
 Slightly happy
 Fairly happy
 Very happy
• I want to learn new things and get better at my job
 Strongly Disagree
 Disagree
 Agree
 Strongly Agree
• I feel good about what I do at work.
 Not at all
 Very Rarely
 Sometimes
 Frequently
• I'm happy and satisfied with where I work
 Strongly Disagree
 Disagree
 Agree
 Strongly Agree
• I can handle my work well and have a good balance between work and life.
 Strongly Disagree
 Disagree
 Agree
 Strongly Agree