Diversity, Equity, and Inclusion (DEI) Pulse Survey Template

Diversity, Equity, and Inclusion (DEI) Pulse Survey Template

Example Survey

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

‍

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