Template for Vital Signs Survey

This survey is going out to all employees to measure your satisfaction in a number of "vital signs" of effective organizations. Your answers are completely anonymous and flow into a third-party vendor. No one can link what you say to you. Please be completely honest....we will listen to what you say and take corrective actions. Together we can help our company get even better!

1. Please indicate your current role:
1. I am an Executive
2. I am in a management/supervisory role
3. I am in an office/support staff role
4. I am a clinician or field worker
5. Other


Now please continue with the survey:

2. I can tell my supervisor what I think.
Disagree Strongly Disagree Neither Agree nor Disagree Agree Agree Strongly
3. Favoritism is not a problem in my area.
4. Our leaders help us do our jobs better.
5. Our supervisor listens to our ideas and concerns.
6. My supervisor tells me how I'm doing.
7. My supervisor treats me with respect.
8. My supervisor keeps me informed.
Disagree Strongly Disagree Neither Agree nor Disagree Agree Agree Strongly
9. I know what is expected of me.
10. I believe we are doing the right work and offering the right goods and services to our market.
11. Upper management tells us about company goals.
12. Upper management values our ideas and suggestions.
13. I am confident of fair management.
14. I fully trust the top leadership of our organization.
Disagree Strongly Disagree Neither Agree nor Disagree Agree Agree Strongly
15. My job is secure if I do good work.
16. I fully trust my first line leaders: those I directly report to.
17. I am proud of my job and my work.
18. I am paid fairly for this kind of work.
19. I clearly know the top goals of our organization.
20. Our benefit programs meet most of my needs.
21. I am getting enough training to do my job well, including both technical/skills training and interpersonal/leadership skills training.
22. My job is leading to the kind of future I want.
23. Working here is a good deal for me.
24. People are held accountable for poor behavior or work. People don't "get away with stuff."
25. We have accurate and compelling scoreboards to tell us how we and the organization are doing on our top goals.
26. Our policies and procedures make sense.
Disagree Strongly Disagree Neither Agree nor Disagree Agree Agree Strongly
27. If the company does well, I will do well.
28. People here cooperate well.
29. I have sufficient resources (time, material, equipment, budget) to do my job well.
30. Most people are doing their best work.
31. We do a good job for our customers.
32. Myself and others are held accountable for what we do well or not well.
33. We have the resources to meet customers' needs.
34. I understand how my work affects customers.
Disagree Strongly Disagree Neither Agree nor Disagree Agree Agree Strongly
35. I can take action to satisfy customers.
36. I feel satisfied at the end of my work week: I feel I have added value in important ways to the most important things.
37. Satisfying customers is most important.
38. I am treated as a valued customer by my leaders and others in the team.
39. I am not expected to sacrifice quality to get the job done.
40. I enjoy working here and generally look forward to coming to work each day.


Please think very carefully about these last questions and answer them honestly and thoroughly:

41. After my experiences working here, I would recommend this company as a place to work to a friend or colleague.
0: Strongly Disagree 1 2 3 4 5 6 7 9 10: Strongly Agree
42. If I were one of our customers, I would definitely recommend our services to a friend or colleague.

0: Strongly Disagree 1 2 3 4 5 6 7 9 10: Strongly Agree
43. What is one thing you like best about working for this agency?


44. What do you like least or find frustrating as you work here?

45. What is a suggestion you have on something you would like to see improved?

46. What final comment, suggestion or critique would you like to send forward to our top leadership? Take your time...we will listen!