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Workplace Safety Climate and Incident Reporting Survey

Measures how safe employees feel day-to-day, how strong your safety culture and reporting habits actually are, and what stops people from speaking up — with an AI follow-up that reconstructs a real near-miss or incident and what would change how it's handled next time.

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샘플 질문

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질문 14개 · 약 7분
Q01
메시지

Thanks for taking a few minutes on this. We want an honest picture of how safe work feels day-to-day and whether our reporting process actually works — your name is never attached to your answers. About 8 minutes.

Q02
객관식필수

In the last 12 months, how many workplace safety trainings have you completed?

  • None
  • One
  • Two to three
  • Four or more
Q03
의견 척도필수

Overall, how safe do you feel doing your day-to-day tasks at work?

척도: 1 – 10
최소:Not safe at all최대:Extremely safe
Q04
매트릭스필수

How much do you agree with each statement about safety where you work?

5개 행 × 5개 열
  • Safety equipment and PPE are well-maintained and available when I need them.
  • Safety procedures for my role are clear and easy to follow.
  • I feel comfortable raising a safety concern without fear of blame.
  • My supervisor treats safety as a genuine priority, not just a checkbox.
  • I know exactly how to report a safety incident or near-miss.
열: Strongly disagree · Disagree · Neutral · Agree · Strongly agree
Q05
객관식필수

In the last 6 months, have you personally experienced or witnessed a workplace safety incident or near-miss?

  • Yes, and I reported it
  • Yes, but I did not report it
  • No, not that I'm aware of
Q06
객관식

What, if anything, has stopped you from reporting a safety concern in the past?

  • Didn't think it was serious enough
  • Wasn't sure who to tell or how
  • Worried about blame or repercussions
  • Didn't think anything would change as a result
  • Too busy or forgot
Q07
최선·최악 선택형(MaxDiff)필수

Which of these would do the most, and the least, to improve safety in your day-to-day work?

  • Better personal protective equipment (PPE)
  • More frequent safety training
  • Clearer safety signage and labeling
  • Faster response when incidents are reported
  • Additional staffing during high-risk tasks
  • Better lighting and facility maintenance
  • More open communication about past incidents
세트별 최선·최악 선택최선:Would improve safety the most최악:Would improve safety the least
Q08
AI 인터뷰

Reconstruct one specific near-miss or safety incident the respondent experienced or witnessed in the last 6 months: what happened, what they did in the moment, and whether they reported it. If they reported it, ask what happened after — did anything change? If they didn't report it, dig into the real reason (not just the checkbox reason) and ask what would have made them report it. Keep it concrete and behavioral, not hypothetical.

Q09
평점 척도필수

How confident are you that management actually acts on safety concerns once they're reported?

범위: 1 – 5
최소:Not at all confident최대:Extremely confident
Q10
장문형

What's one change that would make you feel safer at work? Be as specific as you'd like.

Q11
객관식

Which area of the business do you work in? (Template note: replace these with your own department list before launching.)

  • Operations
  • Warehouse/Production
  • Office/Administrative
  • Field/Delivery
  • Other
  • Prefer not to say
Q12
객관식

How long have you worked here?

  • Less than 6 months
  • 6 months to 2 years
  • 2 to 5 years
  • More than 5 years
  • Prefer not to say
Q13
객관식

What shift do you typically work?

  • Day shift
  • Evening shift
  • Night shift
  • Rotating/variable shift
  • Prefer not to say
Q14
메시지

Thanks for your honesty — this really helps. Responses are combined into a safety report for leadership, and specifics from the follow-up conversation help us fix real gaps in how incidents get reported and handled.

포함된 기능

  • AI 후속 질문

    정형화된 설문이 놓치는 세부 내용을, 주관식 답변에 맞춰 AI가 심층 질문으로 끌어냅니다.

  • 주의력 확인 장치

    성의 없는 답변과 저품질 응답자를 걸러내는 내장 안전장치입니다.

  • AI가 작성한 문안

    문구, 질문 순서, 분기 로직까지 AI가 연구 목표에 맞춰 작성합니다.

  • 자동 리포트

    응답이 모이면 주요 주제, 인용문, 이해하기 쉬운 요약이 자동으로 작성됩니다.

다른 서비스와 비교

다른 설문 도구의 가장 유사한 템플릿을 검토했습니다. 그 도구들이 잘하는 점과, 이 템플릿이 한발 더 나아가는 지점을 정리했습니다.

이 템플릿을 선택하는 이유

  • Goes beyond scaled ratings with an AI follow-up interview that reconstructs one specific near-miss or incident and probes what would change how it's handled next time — something static forms can't do
  • Combines quantitative signals (opinion scale on daily safety, a matrix of safety-culture agreement statements, and a MaxDiff to rank what would most improve day-to-day safety) with open-ended long-text on what change would make people feel safer
  • Directly measures reporting barriers with a dedicated question on what's stopped people from reporting, plus a rating on whether management actually acts on concerns — closing the loop from perception to action
  • Segments results by department, tenure, and shift so safety leaders can see where risk and silence are concentrated, then auto-generates a summary report from combined responses

SurveySparrow

Free Workplace Safety Templates That Actually Work

This reads as a roundup/landing page of multiple free workplace safety templates rather than a single fielding-ready survey. SurveySparrow's conversational chat-style UI is a reasonable fit for this topic, but the page is oriented toward browsing templates rather than one deep, ready-to-send instrument.

잘하는 점

  • Chat-style conversational format that can feel more human than a plain form
  • Multiple free template variants to choose from
  • Likely easy to customize and brand within their builder

아쉬운 점

  • No adaptive AI follow-up — questions are fixed regardless of what a respondent says
  • No mention of voice AI interviews or automated per-response quality scoring
  • Positioned as a template gallery/guide rather than a single deployable safety-climate instrument

Jotform

Workplace Safety and Concerns Form Template

A straightforward form-builder template for logging safety concerns, which is useful for intake but is structurally a form rather than a survey designed to measure safety climate. It benefits from Jotform's drag-and-drop customization and widget ecosystem, but has no research-style question logic built in.

잘하는 점

  • Highly customizable fields via drag-and-drop form builder
  • Easy to embed or share for quick concern intake
  • Free tier available for basic use

아쉬운 점

  • No adaptive AI interviewing or incident reconstruction — just static form fields
  • No automated quality scoring of open-text responses
  • Framed as a concerns/incident form, not a full safety-climate and reporting-culture survey

QuestionPro

Employee Safety Survey Questions + Sample Questionnaire Template

This is primarily a guide-style page with sample survey questions and explanations rather than a one-click deployable template. QuestionPro brings established survey-research credibility and analytics, but the page itself reads as educational content plus a downloadable question set.

잘하는 점

  • Sample questionnaire draws on established survey-research question types
  • Backed by QuestionPro's broader analytics and dashboard tooling
  • Useful as a reference for building question logic manually

아쉬운 점

  • No adaptive AI follow-up or incident reconstruction — questions are pre-written and static
  • Page functions as a guide/article with sample questions, not a ready-to-field instrument
  • No mention of voice AI or automated quality scoring of responses

Typeform

Employee Safety Survey Template

A polished one-question-at-a-time conversational survey template, which is the closest product analog to QuestionPunk's interface style. It likely supports branching logic for a smoother respondent experience, but has no AI-driven follow-up or incident reconstruction built in.

잘하는 점

  • Clean one-question-at-a-time conversational UX
  • Conditional/branching logic to route respondents
  • Easy to theme and share, good completion rates typical of Typeform

아쉬운 점

  • No adaptive AI interviewer — follow-up questions are pre-set, not generated from the respondent's actual answer
  • No voice AI interview option or automated per-response quality scoring
  • No built-in mechanism to reconstruct a specific near-miss/incident in the respondent's own words

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