Required Input: Survey Example

This is an example of how a questionnaire form can be validated before the information is submitted through the internet.
In this example, the computer will check your responses before submitting them. If you have neglected to respond to
one or more of the items below, the computer will let you know which items you skipped by highlighting them in yellow.
This will give you an opportunity to go back and respond to the items you skipped. If you press the submit button again, the
computer will submit (send) your response to the database.

Try it out. Respond to one or more of the items below and then press the [Submit] button at the bottom of the page to see what happens.

Welcome to this year's Employee Opinion Survey!


Keep in mind that your responses help us to become a better place to work. So, you are encouraged to respond to all items on the questionnaire.

Information and Communication

Agree Disagree Strongly
  1. The Senior Management Team fosters an environment of open and effective communication.
  1. I have a clear and concise understanding of my teams business strategy.
  1. I understand how my individual objectives link to my teams business strategy.
  1. I understand how my teams business strategy links directly to the business strategy for the company.
  1. Important changes within the company are communicated effectively.
  1. I am aware of and understand the company policies and procedures.
  1. I am familiar with the Employee Benefits Package
  1. The employee newsletter is useful in keeping me updated.
  1. The website is a useful forum for company updates.
This pair of follow-up items can provide you with valuable suggestions organized by survey item.

Follow-up Items:
Which topic in this grouping is the most important to you?
What is your suggestion on how to improve this?

Work Environment

Agree Disagree Strongly
  1. I have the tools, supplies and equipment necessary to perform my job.
  1. I enjoy working in my department.
  1. Employees work together and are dependent upon one another to achieve a common goal.
  1. Employees at my location promote a professional work environment.
  1. I am satisfied with the productivity and efficiency of my team.
  1. My direct manager and I have a good working relationship.
  1. I feel that I contribute to a positive, productive work environment.
  1. Meetings are effectively conducted to make decisions and/or inform those in attendance.
Which topic in this grouping is the most important to you?
What is your suggestion on how to improve this?
  1. Please rank from 1-7, where 1= most important and 7= least important, the categories you addressed above as they relate to your employment satisfaction (each number 1,2,3,4,5,6,7 is only used once):
    Work Environment
    Job Satisfaction
    Work/Life Balance

  2. How would you rate our company as a place to work compared to other companies you know about or have worked for? And why?
    -Not Applicable

  3. Are there any benefits you would like to see offered?
    Employee Assistance
    Additional Time Off
    Travel Allowance
    Retirement Planning

    If other, please list here:
    Which topic in this grouping is the most important to you? Please enter any comments/suggestions.

  4. If you had an opportunity to make any change you wanted to make the company
    a better place to work, what ONE improvement would you make?


    Reminder: this survey is being administered by a third party to ensure respondent confidentiality by our employees. Any demographic information collected below will be aggregated at the highest level and put into standard reports so that we can do roll up analyses of the overall organization (as opposed to small groups). Individual responses will not be disclosed by our third party vendor to company employees, nor will any demographic information be used so that it makes it easy to guess who might be responding a certain way.

  5. My job category is:
    Research and Dev

  6. Length of Service:
    Less than 1 year
    1-3 years
    4-9 years
    10+ years

  7. Location:
    A office
    B office
    C office
    D office

  8. Additional Comments: