Work Life Balance Survey Template

1. What is your age?

The answer should be a single choice:

1. Under 18
2. 18-25
3. 26-35
4. 36-45
5. 46-55
6. 56 or above

2. What is your gender?

The answer should be a single choice:

1. Male
2. Female
3. Other

3. What is your current job title?

The answer should be a text input.

4. What is your current employment status?

The answer should be a single choice:

1. Full-time
2. Part-time
3. Self-employed
4. Other

5. How often do you feel stressed because of work?

The answer should be a single choice:

1. Always
2. Often
3. Sometimes
4. Rarely
5. Never

6. How often do you bring work home with you?

The answer should be a single choice:

1. Always
2. Often
3. Sometimes
4. Rarely
5. Never

7. How satisfied are you with the balance between your work and personal life?

The answer should be a single choice:

1. Very satisfied
2. Satisfied
3. Neutral
4. Dissatisfied
5. Very dissatisfied

8. Do you feel that your employer supports work-life balance?

The answer should be a single choice:

1. Strongly agree
2. Agree
3. Neither agree nor disagree
4. Disagree
5. Strongly disagree

9. How often do you take time off for personal reasons?

The answer should be a single choice:

1. Always
2. Often
3. Sometimes
4. Rarely
5. Never

10. Does your workplace offer flexible work arrangements (e.g. telecommuting, flexible hours)?

The answer should be a single choice:

1. Yes
2. No
3. Not sure

11. Are you aware of any work-life balance initiatives offered by your employer?

The answer should be a single choice:

1. Yes
2. No
3. Not sure

12. Have you used any work-life balance initiatives offered by your employer?

The answer should be a single choice:

1. Yes
2. No
3. Not sure

13. How effective do you feel the work-life balance initiatives offered by your employer are?

The answer should be a single choice:

1. Extremely effective
2. Very effective
3. Neutral
4. Ineffective
5. Very ineffective

14. How often do you prioritise your personal life over work?

The answer should be a single choice:

1. Always
2. Often
3. Sometimes
4. Rarely
5. Never

15. How important is work-life balance to you?

The answer should be a single choice:

1. Extremely important
2. Very important
3. Somewhat important
4. Not very important
5. Not at all important

16. How do you manage your work-life balance? (Select all that apply)

The answer should be a multiple choice:

1. Time management
2. Setting boundaries
3. Delegating tasks
4. Prioritising responsibilities