Diversity, Equity, and Inclusion (DEI) Pulse Survey Template
Title DEI Survey
Welcome Message In order to make COMPANY a more diverse, equitable and inclusive company, we would love to hear your feedback. Please take the time to fill out this survey when you get a moment!
Dropdown Title 1 Race: What racial/ethnic groups do you belong to?
Dropdown options: Black or African American, East Asian, Hispanic/Latino/a, Middle Eastern, American Indian or Alaska Native, South Asian, Southeast Asian, Native Hawaiian or Other Pacific Islander, White, Multiple options above, Other
Dropdown Title 2 Gender Identity: How do you describe your gender identity?
Dropdown options: Female, Male, Gender-queer or non binary, Agender, Multiple options above, Not specified above
Dropdown Title 3 Gender Identity: Do you identify as transgender (or another non-cisgender identity?)
Dropdown options: Yes, No
Dropdown Title 4 Sexual Orientation: What is your sexual orientation?
Dropdown options: Lesbian, Gay, Bi-sexual, Heterosexual or Straight, Asexual, Pansexual, Queer, None of the above
Dropdown Title 5 Disability Status: Do you identify as a person with a disability or are you a person with accessibility needs?
Dropdown options: Yes, No, Choose not to answer
Linear Scale Question 1 COMPANY NAME values diversity
1 - Strongly Disagree
2
3
4
5 - Strongly Agree
Linear Scale Question 2 Leadership understands that diversity is critical to our future success.
1 - Strongly Disagree
2
3
4
5 - Strongly Agree
Linear Scale Question 3 COMPANY NAME invests time and energy into building diverse teams.
1 - Strongly Disagree
2
3
4
5 - Strongly Agree
Linear Scale Question 4 I feel my unique background and identity (i.e. my differences) are valued at COMPANY NAME.
1 - Strongly Disagree
2
3
4
5 - Strongly Agree
Linear Scale Question 5 I feel a sense of belonging at COMPANY NAME.
1 - Strongly Disagree
2
3
4
5 - Strongly Agree
Linear Scale Question 6 I feel respected by my colleagues.
1 - Strongly Disagree
2
3
4
5 - Strongly Agree
Linear Scale Question 7 People from all backgrounds and with a range of identities have opportunities to advance their careers at COMPANY NAME.
1 - Strongly Disagree
2
3
4
5 - Strongly Agree
Linear Scale Question 8 I feel supported in my career growth at COMPANY NAME.
1 - Strongly Disagree
2
3
4
5 - Strongly Agree