Culture Survey Form

The survey form aims to gather feedback on various aspects of the workplace, including communication and feedback, resp
learning and development, and inclusion and exclusion. The responses to these questions will help identify areas where the org
well and areas that may need improvement. By understanding the experiences and perceptions of employees, the organization c
creating a more supportive and inclusive workplace for everyone.

Personal information Department Name

Position: Gender:

Culture Engagement Survey Template

Always= 5, Frequently= 4, Sometimes = 3, Seldom = 2, Never = 1

Respect and Safety

I feel respected in the organization.

If I made a mistake at the workplace, I feel safe disclosing it.

In our organization, women are treated respectfully and are not made to feel uncomfortable.

I feel the organization provides fair treatment to all.

I feel unsupported in the workplace.

I feel disappointed by the unprofessional behavior of my colleagues.

Colleagues do not ask for work-related help as they fear they would be made fun of.

Some colleagues are judged negatively when they behave in the same way as other colleagues.

My Colleagues use offensive language in the workplace. (1 is never and 5 is always)

My colleagues make personal comments that may make people uncomfortable.

I feel there is more support for males than females in the organization.

My colleagues treat me professionally at the workplace.

Communication and Feedback

If I have a question, I could ask my colleagues.

I have the freedom to speak up about disagreements on issues with anyone in the organization.

All colleagues across all positions get similar feedback on similar mistakes.

My teammates appreciate my work done well.

Evaluation and performance appraisal in our organization is fair.

I feel the organization appreciates all employees for their efforts.

My immediate superior appreciates me for work done well.

My organization values my opinion.

All colleagues, male or female, get similar feedback on similar mistakes.

Learning and Development

The organization encourages and supports my learning to perform my tasks and new things.

My colleagues know what is expected from them at the workplace.

My colleagues know how their work contributes to the goal of the company.

My team is very supportive.

My organization gives autonomy to all.

I can offer recommendations/ideas for new projects or changes in procedures in the organization.

If I have questions, I could ask my immediate supervisor for help.

My colleagues understand the importance of time and completing tasks on time.

Exclusion and Inclusion

I feel excluded from an important meeting.

I feel uncomfortable sharing my background or identity with colleagues.

Certain colleagues or groups are favored over others in decision-making processes.

I have witnessed or experienced discrimination or prejudice in the workplace.

I feel that my contributions are overlooked or undervalued by my colleagues or superiors.

What are the most significant strengths that set our organization apart?

How can we improve our operations and achieve better results?

cation and feedback, respect and safety,
ntify areas where the organization is doing
loyees, the organization can work towards

Marketing
Male

Never = 1

Always

Frequently

Sometimes

Seldom

Never

Frequently
Always