すべてのテンプレート
Strategy & Transformation

Work Schedule Flexibility Request Survey

Captures why employees are requesting changes to their work schedule — shifted hours, compressed weeks, remote days, or reduced hours — and how urgent and job-critical the need is. Built for HR and People teams shaping flexible-work policy, with an AI follow-up that digs into the real constraint behind the request and what a workable compromise would look like.

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

Hi! We're gathering input on work schedule flexibility so we can build fair, workable policies. Your responses are completely confidential and anonymized. This will take about 8 minutes, and your answers help shape real decisions — not just get filed away.

Q02
選択式必須

Are you currently requesting, or seriously considering requesting, a change to your work schedule?

  • Yes, I have an active request
  • Not yet, but I'm considering one
  • No, just sharing feedback on flexibility in general
Q03
選択式必須

What type of schedule change would help you most? Select all that apply.

  • Shifted start/end times
  • Compressed workweek (e.g., 4 longer days)
  • More remote or hybrid days
  • Reduced hours / part-time
  • Job share arrangement
  • Flexible hours with no fixed schedule
Q04
選択式必須

What is the primary reason behind this request?

  • Childcare or family care
  • Eldercare or caregiving for a dependent
  • Commute time or cost
  • Physical health condition
  • Mental health or wellbeing
  • Education or professional development
  • Second job or personal business
Q05
オピニオンスケール必須

If granted, how much would this change improve your ability to do your job well?

スケール: 1 – 5
最小:No improvement最大:Major improvement
Q06
オピニオンスケール必須

How urgent is this need for you right now?

スケール: 1 – 7
最小:Not urgent at all最大:Extremely urgent
Q07
マトリクス

If this schedule change were approved, how do you think it would affect the following?

4行 × 5列
  • Collaboration with your team
  • Attendance at key meetings
  • Your overall workload
  • Responsiveness to clients or stakeholders
列: Much worse · Slightly worse · No change · Slightly better · Much better
Q08
ランク付け

If your first-choice schedule change can't be fully granted, rank these alternatives from most to least workable for you.

  1. Fully remote on select days
  2. Shifted start/end times
  3. Compressed workweek
  4. Reduced hours / part-time
  5. Job share arrangement
ドラッグして順位を付ける
Q09
AIインタビュー

Probe the real constraint behind this respondent's schedule change reason: what specifically happens on days or hours where the current schedule doesn't work, and what has already gone wrong or nearly gone wrong because of it. Anchor on their stated urgency and primary reason. Explore whether a partial accommodation (e.g., one flex day, a 1-2 hour shift) would meaningfully resolve the issue, or whether only the full request works and why. If they said they're 'just sharing feedback' with no active request, ask what would need to change for them to actually submit one.

Q10
選択式

How long do you expect to need this schedule change?

  • Temporary, under 3 months
  • 3 to 12 months
  • Indefinite or ongoing
  • Not sure yet
Q11
自由回答(長文)

Have you already tried any workarounds or informal arrangements with your manager or team? Briefly describe what worked or didn't.

Q12
プルダウン

Which department or team are you part of? (Replace with your organization's department list.) (Template note: swap in your actual department taxonomy before launching.)

  • Department A
  • Department B
  • Department C
  • Department D
  • Prefer not to say
Q13
選択式

How long have you been with the organization?

  • Less than 1 year
  • 1-3 years
  • 4-7 years
  • 8+ years
  • Prefer not to say
Q14
選択式

What is your employment type?

  • Full-time
  • Part-time
  • Contract or temporary
  • Prefer not to say
Q15
メッセージ

Thank you for sharing this — it's genuinely useful. Your responses will be reviewed alongside others to shape our approach to schedule flexibility, and individual requests will be followed up on separately by your HR contact.

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

  • Includes an AI follow-up interview that probes the real constraint behind the schedule change request and explores what a workable compromise would look like, going beyond a static intake form
  • Combines structured screening (type of change requested, urgency, primary reason) with a matrix question assessing perceived impact across multiple dimensions if the change were approved
  • Captures nuance through a ranking question for fallback alternatives and a long-text question on prior informal workarounds already tried with a manager
  • Segments by department, tenure, and employment type so HR and People teams can analyze patterns for fair, workable flexible-work policy, with an automated report generated at the end

Jotform

Work Schedule Change Request Form Template

A ready-to-use fielding form for employees to submit a schedule change request, built on Jotform's drag-and-drop form builder with standard field types. It's oriented toward capturing the request itself (what change, effective date) rather than probing the underlying constraint or urgency in depth. Good for basic intake, but lighter on the reasoning/context side than a survey built for policy analysis.

優れている点

  • Fast to deploy and customize using Jotform's widely-used form builder
  • Likely supports file uploads, e-forms, and integrations typical of Jotform templates
  • Simple, familiar UX for employees submitting a one-off request

物足りない点

  • Static field-based form with no adaptive follow-up questioning to dig into the real reason behind a request
  • No mechanism to explore trade-offs or compromise scenarios if the exact request can't be granted
  • No automated quality scoring or transparent methodology behind how responses are interpreted

SurveySparrow

Work Schedule Change Request Form Template

A conversational-style form template for collecting employee schedule change requests, in line with SurveySparrow's chat-like survey format. It focuses on capturing the request and basic justification rather than layered analysis like urgency scoring, ranked fallback options, or manager-workaround history. Positioned as an HR intake tool rather than a deep-dive research instrument.

優れている点

  • Conversational, one-question-at-a-time flow that can feel more approachable than a traditional form
  • Employee-focused template ready to adapt with company branding
  • Part of a broader HR template library, suggesting integration with other people-ops workflows

物足りない点

  • No adaptive AI interviewing to probe deeper into the actual constraint driving the request
  • No ranking or matrix-style questions to compare alternative schedule options or impacts
  • No published, transparent prompt/methodology for how follow-up or scoring works

よくあるご質問

「Work Schedule Flexibility Request 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:「Hi! We're gathering input on work schedule flexibility so we can build fair, workable policies. Your responses are compl…」・「Are you currently requesting, or seriously considering requesting, a change to your work schedule?」・「What type of schedule change would help you most? Select all that apply.」。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。

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