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Employee & HR

Employee Complaint Intake and Follow-Up Survey

A confidential intake form for employees to document a workplace complaint or concern, capturing what happened, who's involved, severity, and desired resolution. An AI follow-up interview gently reconstructs the specific timeline and details so HR gets an actionable, well-documented account instead of a vague summary.

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設問の例

テンプレートの内容をプレビューできます。すべての設問は公開前に自由に編集できます。

全15問・約8分
Q01
メッセージ

Thank you for coming forward. This form helps you document a workplace concern so it can be reviewed and addressed appropriately. Your responses are handled confidentially by HR. It takes about 6-8 minutes, and you can pause and return at any time.

Q02
選択式必須

What type of issue are you reporting?

  • Harassment or discrimination
  • Bullying or disrespectful behavior
  • Unsafe working conditions
  • Unethical or dishonest conduct
  • Policy or procedure violation
  • Compensation, scheduling, or workload dispute
  • Retaliation for a prior report
Q03
選択式

Who is this complaint primarily about?

  • My direct manager
  • A manager or leader outside my team
  • A coworker on my team
  • A coworker in another team
  • A vendor, client, or external contact
  • Multiple people
  • Prefer not to say
Q04
日付

When did the most recent incident related to this complaint occur?

Q05
選択式必須

In the last 6 months, how often has this type of incident occurred?

  • This is the first time
  • A few isolated times
  • Repeatedly, on and off
  • Constant or ongoing
Q06
オピニオンスケール必須

How severe do you consider this issue to be?

スケール: 1 – 5
最小:Minor concern最大:Critical, needs urgent action
Q07
選択式必須

Have you previously reported this issue to anyone?

  • No, this is the first report
  • Yes, to my manager
  • Yes, to HR
  • Yes, to another leader
  • Yes, informally to a colleague
Q08
マトリクス必須

Thinking about this situation, how much do you agree with each statement?

4行 × 5列
  • I feel safe raising this concern
  • I believe appropriate action will be taken
  • This has affected my ability to do my job
  • This has affected my wellbeing outside of work
列: Strongly disagree · Disagree · Neutral · Agree · Strongly agree
Q09
自由回答（長文）必須

Please describe what happened, including approximate dates, the people involved, and any witnesses.

Q10
選択式必須

What outcome are you hoping for from this report?

  • A formal investigation and corrective action
  • A mediated conversation between the parties
  • A change to a policy or process
  • I mainly wanted this documented for the record
  • I'm not sure yet
Q11
AIインタビュー

Reconstruct the specific timeline of the most recent incident described: what was said or done, in what order, who was present, and how the respondent and others reacted in the moment. Probe for concrete details (exact words, dates, locations, any documentation like emails or messages) rather than general impressions. If the respondent indicates this is repeated or ongoing, ask them to walk through one other clear example. If they seem hesitant or vague about naming people involved, reassure them once about confidentiality and gently ask again before moving on.

Q12
設問

If you have any supporting documents, screenshots, or messages related to this complaint, you may upload them here (optional).

Q13
プルダウン

Which department do you work in? (Optional, helps HR route this report)

  • Sales
  • Marketing
  • Engineering or Product
  • Operations
  • Customer Support
  • Finance
  • Human Resources
  • Other
  • Prefer not to say
Q14
選択式

How long have you worked at the company?

  • Less than 6 months
  • 6 months to 2 years
  • 2 to 5 years
  • More than 5 years
  • Prefer not to say
Q15
メッセージ

Thank you for trusting us with this report. It will be reviewed confidentially by HR, and where appropriate, someone will follow up with you directly about next steps.

含まれる機能

  • AIによる深掘り

    自由回答に合わせてAIが追加で質問し、固定のフォームでは拾えない具体的な内容を引き出します。

  • 注意確認設問

    急いだ回答や質の低い回答者を除外する仕組みを標準で備えています。

  • AIが作成する設問文

    文言、設問の順序、条件分岐をAIが調査の目的に合わせて作成します。

  • 自動レポート

    回答が集まると、テーマ、引用、わかりやすい要約が自動で作成されます。

他ツールとの比較

ほかのアンケートツールで最も近いテンプレートを調べました。それぞれの優れている点と、このテンプレートがさらに踏み込んでいる点をまとめています。

このテンプレートを選ぶ理由

  • Captures structured intake details (issue type, parties involved, severity, frequency, prior reports) alongside a matrix of agreement statements and a detailed open narrative, so HR gets both quantifiable and qualitative context.
  • An AI follow-up interview specifically reconstructs the timeline of the most recent incident (what happened, who was involved, in what order), turning a vague complaint into an actionable, well-documented account.
  • Supports file uploads for supporting evidence (screenshots, messages, documents) directly within the same flow.
  • Opens and closes with confidentiality-focused chat messages, and collects optional routing details (department, tenure) without forcing disclosure that could feel invasive.

Jotform

Employee Formal Complaint Form Template

A standard fielding-ready form builder template for capturing formal employee complaints, likely with fields for incident details and parties involved. It's a static form-fill experience rather than an interview, so any follow-up clarification depends entirely on how HR staff manually review free-text answers.

優れている点

  • Ready-to-use, customizable form builder with drag-and-drop fields
  • Wide template library and integrations typical of Jotform's ecosystem
  • Simple to deploy for basic complaint intake

物足りない点

  • No adaptive AI follow-up to probe vague or incomplete incident descriptions
  • No automated per-response quality scoring to flag weak submissions
  • No transparent, published interview prompts or methodology

SurveyMonkey

Employee Complaint Form Template

A conventional survey template for collecting employee complaints using SurveyMonkey's standard question types. It's built for one-shot data collection and reporting, not for reconstructing an incident timeline through dialogue. Strong for aggregate reporting, less suited to building a single well-documented case file.

優れている点

  • Established survey platform with solid reporting/analytics dashboards
  • Easy to distribute and collect responses at scale
  • Familiar UI for respondents and HR teams alike

物足りない点

  • No adaptive AI interview to reconstruct incident timelines or dig into specifics
  • No voice AI or guided screen-share task options
  • No automated quality scoring of individual responses

SurveySparrow

Free Employee Complaint Form Template

A free, conversational-style form template aimed at making complaint intake feel more human than a plain form. It likely offers a chat-like UI for question flow, but this is scripted branching rather than a true adaptive AI interview that follows up dynamically based on what the employee actually writes.

優れている点

  • Conversational, chat-style interface that can feel friendlier than a static form
  • Free to use, lowering the barrier to entry
  • Mobile-friendly presentation typical of SurveySparrow forms

物足りない点

  • Conversational UI is pre-scripted, not a genuine adaptive AI follow-up that reacts to response content
  • No automated quality scoring of individual responses
  • No published, transparent methodology for how follow-up questions are generated

Typeform

Employee Complaint Form Template

A polished, one-question-at-a-time form template known for good respondent experience and design. It's still a fixed sequence of questions defined at build time, so it can't dynamically reconstruct a specific incident timeline the way a follow-up interview can.

優れている点

  • Clean, one-at-a-time question flow with strong visual design
  • Good completion rates typical of Typeform's UX
  • Easy embedding and sharing across channels

物足りない点

  • Static logic-jump branching only, no adaptive AI probing based on free-text answers
  • No automated per-response quality scoring
  • No voice AI interview option or guided screen-share tasks

よくあるご質問

「Employee Complaint Intake and Follow-Up Survey」テンプレートにはどのような設問が含まれていますか？

すぐに使える設問が15問含まれており、最初の設問は次のとおりです：「Thank you for coming forward. This form helps you document a workplace concern so it can be reviewed and addressed appro…」・「What type of issue are you reporting?」・「Who is this complaint primarily about?」。すべての設問は上でプレビューでき、自由に編集できます。

このアンケートの回答にはどのくらい時間がかかりますか？

回答者は通常、15問を約8分で回答し終えます。

テンプレートは編集できますか？

はい。公開前であれば、すべての設問、選択肢、順序を編集できます。設問の追加や削除のほか、調査の目的に合わせた作り直しをAIエディターに依頼することもできます。

このテンプレートは無料で使えますか？

はい。エディターで開けば、すぐに編集を始められます。お試しにアカウントは不要で、無料プランでアンケートを公開できます。

公開の準備はできましたか？

このテンプレートをエディターで開いてみてください。最初の回答者が目にする前に、すべてを自由に変更できます。

このテンプレートを使う無料で始める

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