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Preparing to Return to the Workplace
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Survey SectionSurvey FactorQuestion TextNotes
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Return ReadinessReturn ReadinessI am confident I can make an effective transition back to the workplace
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Return ReadinessReturn ReadinessI am looking forward to returning to the workplace
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Return ReadinessReturn ReadinessI will feel safe being in the workplace when COVID-19 restrictions are lifted
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SupportSupportI am able to transition back to the workplace with minimal disruption to my usual routine/personal life
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SupportSupportI am able to manage any caring responsibilities while transitioning back to work (e.g. child care, looking after dependents)
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SupportSupportI feel confident that I would receive support from coworkers if I needed it
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SupportSupportI have been appropriately involved in my return to work plan
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Manager supportManager supportAre you a people manager? Yes/NoUsed to create branching for remaining questions in the section
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Manager supportManager supportI am confident I can support my direct report(s) in a successful transition back to the workplace
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Manager supportManager supportI have been provided with the resources I need to support my direct report(s) when they return to the workplace
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Manager supportManager supportI have been informed on the health and safety precautions my direct report(s) will need to follow
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Manager supportManager supportI feel equipped to have difficult conversations with my direct report(s) on their return to the workplace
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Manager supportManager supportI have the support I need to manage a phased return of my direct report(s)
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My Role My RoleI have been informed on whether there will be any changes to my role responsibilities when I return to the workplace
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My Role My RoleI have been informed of the responsibilities of my role as I return to the workplace
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My Role My RoleI feel capable to successfully carry out the responsibilities of my role as I return to the workplace
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My Role My RoleI know how my role contributes to the organization's success as I return to the workplace
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WellbeingWellbeingI am feeling energized about returning to the workplace
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WellbeingWellbeingI believe I will be treated fairly by my coworkers as I transition back to the workplace
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WellbeingWellbeingI feel confident that any changes to my personal circumstances will not impact my ability to do my job effectively
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WellbeingEmployee AssistanceI know how to access %ACCOUNT_NAME%'s Employee Assistance Program [other employee support program]
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WellbeingEmployee AssistanceI believe %ACCOUNT_NAME%'s Employee Assistance Program [other employee support program] will meet any needs I may have
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WellbeingEmployee AssistanceI know how to get access to %ACCOUNT_NAME%'s mental health resources
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WellbeingEmployee AssistanceI believe %ACCOUNT_NAME% are providing employees with the mental health resources they need
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WellbeingWellbeingI have been able to maintain my physical health during COVID-19
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SafetyTravelI would feel safe traveling to the workplace when COVID-19 restrictions are lifted
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SafetyTravelI would feel comfortable traveling for work related purposes (e.g. attending offsite meetings) when COVID-19 restrictions are lifted
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SafetyKnowledge of Safety MeasuresI have been informed of the safety measures being put in place when I return to the workplace
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SafetyKnowledge of Safety MeasuresI have been informed of what workplace facilities will be available (e.g. gym, cafeteria, social areas) when I return to the workplace
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SafetyKnowledge of Safety MeasuresI have been informed of what social distancing measures will be in place when I return to the workplace
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SafetyKnowledge of Safety MeasuresI have been informed of what personal protective equipment will be available to me when I return to the workplace
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SafetyComfort with Safety MeasuresI would feel comfortable being in the workplace if [safety protocol e.g. wearing a mask / temperature check / social distancing ] is in placeCreate additional questions for each safety measure
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ConcernsConcernsI know where to raise concerns about transitioning back to the workplace
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ConcernsConcernsI would feel comfortable raising concerns about transitioning back to the workplace
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ConcernsConcernsWhat (if any) are your biggest concerns about returning to the workplace?

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CommentsFree textWhat can %ACCOUNT_NAME% do to support you as you make the transition back to the workplace?
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CommentsFree textWhat has %ACCOUNT_NAME% implemented in response to the COVID-19 pandemic that could help working life in the future? (Flexible work hours, daily stand-ups, project teams)
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DemographicsWhat are your caregiving responsibilities?
Children (part- or full-time)
Other adults
Children and other adults
No caregiving responsibilities
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What is your living status?
Living alone
Living with family
Living with other people
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Where are you currently living?
In usual residence
In other residence (same state/county)
In other residence (different state/county)
In other residence (abroad)
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How do you usually travel to work?
Walk
Cycle
Drive
Taxi
Public Transport
Other, please specify...
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How do you plan to travel to work once the COVID-19 restrictions are lifted?
Walk
Cycle
Drive
Taxi
Public Transport
Other, please specify...
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Are there any travel restrictions in place that could prevent you from returning to the workplace from your current residence?

Yes - legal restrictions
Yes - public transport restrictions
Unsure
No
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Prior to COVID-19 did you work remote?
Always
Sometimes
Never
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Are you a people manager?
Yes
No
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Are you returning from furlough?
Yes
No
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