In the last 30 days, I felt a strong sense of belonging on my team.
Range: 1 – 10
Min: Strongly disagree Mid: Neutral Max: Strongly agree
In the last 30 days, I felt safe to raise concerns without fearing negative consequences.
Scale: 11 (star)
Min: Not at all true Max: Completely true
In the last 3 months, did you experience or witness exclusionary behavior at work?
Yes, experienced directly Yes, witnessed No Prefer not to say
If applicable, briefly describe what happened (please avoid names or identifying details).
Max 600 chars
If applicable, performance evaluations that affected me in the last 6 months were fair.
Scale: 11 (star)
Min: Very unfair Max: Very fair
In the last 30 days, workload was shared fairly within my team.
Range: 1 – 10
Min: Strongly disagree Mid: Neutral Max: Strongly agree
Compared with peers in similar roles, how fairly are you rewarded overall?
Much less fairly Somewhat less fairly About the same Somewhat more fairly Much more fairly Prefer not to say
Thinking about the last 60 days, how much do you agree with each statement?
Rows Strongly disagree Disagree Neither Agree Strongly agree My manager actively seeks diverse viewpoints. • • • • • Meetings I attend include all voices. • • • • • Decisions that affect me are explained clearly. • • • • • Colleagues show respect across differences. • • • • • Work norms accommodate different needs (for example, schedules, accessibility). • • • • •
Rank the areas that would most improve inclusion for you.
Drag to order (top = most important)
Manager support Transparent decision-making Work-life flexibility Career development Pay and recognition
In the last 6 months, which of the following reflect your access to opportunities? (Select all that apply.)
I had equal access to high-visibility work. My development requests were supported. I lacked access to stretch assignments. I was passed over without clear reasons. Not sure/none apply
Quality check: To confirm you're paying attention, please select "Yes".
Name one small change next month that would help you feel more included.
Max 100 chars
In the last 90 days, how likely are you to recommend this company as an inclusive place to work?
Scale: 11 (star)
Min: Not at all likely Max: Extremely likely
What is your primary department or function? (optional)
Engineering/IT Product Sales Marketing Operations HR Finance Customer Support Legal Other
How long have you worked at this company? (optional)
Less than 6 months 6–12 months 1–2 years 3–5 years 6–10 years More than 10 years Prefer not to say
What is your current work arrangement? (optional)
On-site Hybrid Remote Prefer not to say
Are you a people manager? (optional)
What is your location region? (optional)
Americas EMEA APAC Other Prefer not to say
How do you describe your gender? (optional)
Woman Man Non-binary Prefer to self-describe Prefer not to say
If you prefer to self-describe your gender, you may enter it here (optional).
Max 100 chars
Anything else you would like to share to help us improve inclusion? (optional)
Max 600 chars
AI Interview: 2 Follow-up Questions on Inclusion, Fairness, and Belonging
Length: 2 Personality: [Object Object] Mode: Fast
Thank you for your time—your feedback helps us improve.