Employee DEI Pulse: Belonging, Inclusion & Equity
Measures employee perceptions of belonging, psychological safety, fairness, and inclusive practices. Designed for quarterly or monthly pulse deployment with confidential, anonymized responses to inform organizational DEI strategy.
Sample questions
A preview of what’s in the template. Every question is editable before you launch.
In the last 30 days, I felt a strong sense of belonging on my team.
Performance evaluations that affected me in the last 6 months were fair.
Thinking about the last 60 days, please indicate your agreement: My manager actively seeks out and values diverse perspectives in team discussions.
Based on your overall experience in the last 90 days, how likely are you to recommend this organization as an inclusive place to work?
The following questions help us understand experiences across different groups. All are optional, and responses are reported only in aggregate to protect anonymity.
Thank you for completing this survey. Your responses are confidential and will be reported only in aggregate. Your feedback directly informs our inclusion and equity priorities. If anything in this survey raised concerns you'd like to discuss, please reach out to [HR contact / Employee Assistance Program].
In the last 30 days, I felt safe to raise concerns or disagreements without fearing negative consequences.
In the last 30 days, workload was distributed fairly within my team.
In the last 60 days, my colleagues treated me with respect regardless of my background or identity.
Name one change your team or organization could make in the next month that would help you feel more included.
What is your primary department or function?
- Engineering / IT
- Product
- Sales
- Marketing
- Operations
- HR / People
- Finance
- Customer Support
- Legal
- Other
- Prefer not to say
In the last 3 months, did you experience or witness exclusionary behavior at work?
- Yes, experienced directly
- Yes, witnessed
- No
- Prefer not to say
Compared with peers in similar roles, how fairly are you rewarded overall (compensation, recognition, and benefits)?
- Much less fairly
- Somewhat less fairly
- About the same
- Somewhat more fairly
- Much more fairly
- Prefer not to say
In the last 60 days, my ideas and contributions were given fair consideration in meetings and decisions.
Based on your survey responses, we'd like to explore your experiences with inclusion, fairness, and belonging in a bit more depth. Please share what's most on your mind, and our AI interviewer will ask a couple of follow-up questions.
How long have you worked at this organization?
- Less than 6 months
- 6–12 months
- 1–2 years
- 3–5 years
- 6–10 years
- More than 10 years
- Prefer not to say
If you experienced or witnessed exclusionary behavior, please briefly describe the situation. Avoid including names or identifying details.
In the last 6 months, which of the following have you experienced regarding access to growth opportunities? (Select all that apply.)
- I had equal access to high-visibility projects
- My development or training requests were supported
- I received mentorship or sponsorship opportunities
- I lacked access to stretch assignments
- I was passed over for opportunities without clear reasons
- Not sure / None of these apply
Rank the following areas from most to least impactful for improving your experience of inclusion.
- Manager support and advocacy
- Transparent decision-making
- Work-life flexibility
- Career development and growth paths
- Pay equity and recognition
What is your current work arrangement?
- On-site
- Hybrid
- Remote
- Prefer not to say
Are you a people manager?
- Yes
- No
- Prefer not to say
What is your primary work location region?
- Americas
- EMEA
- APAC
- Other
- Prefer not to say
How do you describe your gender?
- Woman
- Man
- Non-binary
- Prefer to self-describe
- Prefer not to say
If you selected 'Prefer to self-describe,' please share how you describe your gender.
What’s included
AI follow-ups
Adaptive probes on open-ended answers that pull out detail a static form would miss.
Attention checks
Built-in safeguards against rushed answers and low-quality respondents.
AI-drafted copy
Wording, ordering, and branching written by the AI — tuned to your research goal.
Auto report
Themes, quotes, and a plain-English summary write themselves once responses come in.
How it compares
We reviewed the closest templates from other survey tools. Here’s what they do well — and where this template goes further.
Why this template
- AI interviews dynamically adapt based on whether respondents are early adopters, skeptics, or non-users—capturing qualitative depth at quantitative scale
- Affordable academic pricing makes it accessible for the university researchers studying AI adoption who are priced out of Qualtrics
- Every AI parameter is logged for replication—critical for the peer-reviewed AI adoption research that competitors' tools cannot support
- AI follow-up questions probe beyond surface-level Likert ratings to uncover root causes of disengagement—something no static survey can do
- Full transparency: every prompt, model, and logic flow is visible to HR researchers, unlike competitor 'black box' AI features
SurveyMonkey
AI Readiness Assessment TemplateSurveyMonkey's AI Readiness Assessment is the closest match—evaluating employee AI awareness, training needs, and current tool usage. Solid for organizational readiness but doesn't specifically measure feature-level adoption, trust, or perceived value of AI capabilities.
What it does well
- Covers employee awareness, comfort levels, and perceived impacts of AI
- Includes risk, compliance, and ethical considerations alongside adoption questions
- Fully customizable with branding, and AI-powered analysis suite for open-ended responses
Where it falls short
- Focused on organizational readiness, not specific AI feature adoption or value perception
- No conversational AI follow-ups to explore trust barriers or adoption hesitancy in depth
- SurveyMonkey's own AI tools (Build with AI, analysis) operate as black boxes—no prompt or model transparency
- No validated trust measurement scales—uses general readiness questions rather than academic trust constructs
Qualtrics
Qualtrics XM for Strategy + ResearchQualtrics publishes extensive research on AI trust gaps (e.g., their State of AI in Employee Experience report analyzing 35,000+ employees) but doesn't offer this as a self-serve template. Their conversational feedback feature is the most competitive AI-interview capability in the market.
What it does well
- Conversational feedback uses generative AI to generate follow-up questions during live surveys—respondents contribute 40% more information
- Own research demonstrates deep expertise in AI trust measurement at organizational scale
- 23 question types including video/audio responses with advanced logic branching
Where it falls short
- No public pre-built AI feature adoption or trust survey template—requires custom building
- Pricing starts at $420/month, making it inaccessible for academic researchers and small teams
- Conversational feedback AI is not researcher-configurable—no access to prompts, no model selection, no parameter logging
- Enterprise-focused platform creates unnecessary complexity for straightforward adoption studies
Jotform
Technology SurveysJotform offers 100+ technology survey templates including some AI-adjacent ones (AI-Augmented Learning Perception, Healthcare AI Bias Awareness, Public Perception of Health AI Tools), but none specifically targeting AI feature adoption and trust in a product or workplace context.
What it does well
- Largest volume of AI-adjacent survey templates among competitors (100+ technology surveys)
- Free plan available with drag-and-drop customization and conditional logic
- Separate AI Agents product offers conversational survey experiences with NLP
Where it falls short
- No dedicated AI feature adoption or trust survey template—closest options are domain-specific (healthcare, education)
- AI Agents are a separate product from form templates—not integrated into survey methodology
- No academic methodology validation, no rubric checking, no scale construction guidance
- AI Agent training is opaque—no visibility into prompts, models, or reasoning logic for researchers
SurveyMonkey
Employee Engagement Survey TemplateWell-established template with benchmarking capabilities and expert-written questions across motivation, leadership, growth, recognition, and culture themes. Strong analytics with filters and crosstabs, but fundamentally limited to static question-and-answer format.
What it does well
- Industry benchmarking data to compare scores against other organizations
- Standardized 5-point Likert scale with built-in scoring methodology
- Extensive customization and segmentation by team or location
Where it falls short
- No AI-powered follow-up questions to explore the 'why' behind low scores
- Static survey format cannot adapt to individual employee responses in real-time
- AI features limited to survey creation assistance, not actual respondent interaction
Typeform
Employee Engagement Survey TemplateVisually appealing one-question-at-a-time conversational format that improves completion rates. Strong UX and branding customization, but the 'conversational' experience is still pre-scripted—it doesn't actually listen and adapt like AI.
What it does well
- Beautiful, conversational one-question-at-a-time interface that feels less like a survey
- Strong integrations with Slack, Microsoft Teams, and 300+ tools
- Excellent mobile experience with no app downloads required
Where it falls short
- No AI follow-up probes—conversational format is just UX, not intelligent adaptation
- No transparent AI methodology—no visible prompts or logic for researchers to audit
- Limited survey methodology rigor—focuses on design over academic-grade question construction
Ready to launch?
Open this template in the editor. Every part is yours to change before the first respondent sees it.