Inclusion Survey - Sample 2
At {Company}, we believe that having a team that reflects the diversity of our community and patients makes us a better organization. It is critical to our success to remove barriers and promote the inclusion of all employees, including those from under-represented groups. We are committed to creating, maintaining, and promoting an equitable culture and organization.

Your information will help us determine where we are now so we can set realistic equity, diversity, and inclusion goals and measure our progress. In turn, we hope to be able to create plans and strategies that improve the work experience of our employees.
 
Your participation in this survey is entirely voluntary and all responses will be kept confidential.

{Company} does not discriminate based on race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, disability status, or age, and will not tolerate discrimination or harassment based on any of the above characteristics.
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My opinions seem to count at work *
Strongly Disagree
Strongly Agree
My immediate manager cares about me as a person
*
Strongly Disagree
Strongly Agree
My immediate manager helps me be successful in my job
*
Strongly Disagree
Strongly Agree
I am proud to work here
*
Strongly Disagree
Strongly Agree
If I contribute to [COMPANY’s] success, I know I will be recognized
*
Strongly Disagree
Strongly Agree
The people I work with treat each other with respect
*
Strongly Disagree
Strongly Agree
My colleagues value the input provided by those in different functions and departments
*
Strongly Disagree
Strongly Agree
If something was going on that I disagreed with I would feel comfortable addressing it
*
Strongly Disagree
Strongly Agree
Everyone here is treated fairly regardless of race, gender, age, ethnic background, disability, sexual orientation, or other differences
*
Strongly Disagree
Strongly Agree
Everyone can contribute to [COMPANY] in their own way
*
Strongly Disagree
Strongly Agree
I can be my authentic self at work
*
Strongly Disagree
Strongly Agree
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