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Employee Wellness Survey Form Template

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Personal Information

Wellness Assessment

Physical Health
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree
I feel physically active and fit regularly.
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I regularly participate in physical wellness activities.
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I have access to resources that support my physical health.
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Mental and Emotional Health
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree
I feel stressed at work most of the time.
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Work demands negatively affect my mental health.
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I have access to mental health resources and support at work.
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Work-Life Balance
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree
I am satisfied with my work-life balance.
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I feel encouraged to take time off when needed.
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
My workload allows for sufficient personal or family time.
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Work Environment and Culture
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree
My workplace supports a culture of health and wellness.
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I feel comfortable discussing my wellness needs with my manager.
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
The company provides sufficient wellness programs that meet my needs.
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree

The Employee Wellness Survey Form Template by WPForms is a useful tool for HR professionals who are looking for a simple way to conduct a survey regarding employee wellness and health in the workplace.

How Does the Employee Wellness Survey Form Template Work?

The Employee Wellness Survey Form Template requires the WPForms Pro License and the Survey and Polls Addon to collect employee responses and display them in visual charts and graphs. Fields include:

  • Personal Information:
    • Full Name: Start by capturing the employee’s full name.
    • Employee ID: This unique identifier keeps the data organized.
    • Email Address: Essential for sending survey results or wellness program updates.
    • Phone Number: Handy for direct communication or urgent wellness updates.
    • Position: Understanding the role to see if certain positions are more affected.
    • Tenure: Insights into how wellness perceptions change with time spent.
  • Wellness Assessment:
    • Physical Health: Gauge perceptions of physical well-being needing attention.
    • Mental Health: Assess the mental and emotional climate within your team.
    • Work-Life Balance: Measure the equilibrium of work duties and personal life.
    • Work Environment: Evaluate the influence of workplace settings on employees.
    • Additional Comments: A space for open-ended feedback for more context.

Once the form is submitted, the Survey and Polls Addon will compile the results of different responses and allow HR professionals to view them in a visual chart or graph to get a clear idea of employee satisfaction levels.

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The Employee Wellness Survey Form Template transforms raw data into actionable insights, allowing you to tailor wellness initiatives that truly resonate with your team’s needs. It is perfect for businesses of all sizes!