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Organizational Culture & Employee Trust Assessment

Measures how employees actually experience your stated values day-to-day — trust, psychological safety, recognition, and manager role-modeling — plus an AI follow-up interview that surfaces the specific moments behind low-trust or low-safety scores. Built for HR, People Ops, and leadership teams running annual or pulse culture audits.

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Sample questions

A preview of what’s in the template. Every question is editable before you launch.

14 questions · ~7 min
Q01
Message

Thanks for taking part in our culture check-in. We want to understand how our stated values actually show up in day-to-day work — your honest answers matter more than diplomatic ones. This takes about 6-7 minutes and your individual responses are kept confidential.

Q02
MatrixRequired

How much do you agree with each statement about your day-to-day experience at work?

5 rows × 5 columns
  • I can raise a mistake or disagreement without fear of it being held against me
  • People here are recognized for good work, not just visibility or tenure
  • Decisions that affect my team are explained, not just announced
  • My team collaborates across departments without unnecessary friction
  • The way people actually behave here matches what leadership says we value
Columns: Strongly disagree · Disagree · Neutral · Agree · Strongly agree
Q03
Opinion ScaleRequired

How likely are you to recommend this company as a great place to work to a friend or former colleague?

Scale: 0 – 10
Min:Not at all likelyMax:Extremely likely
Q04
Multiple ChoiceRequired

In the last 30 days, how often did you see a colleague's differing opinion openly welcomed in a meeting?

  • Never
  • Rarely
  • Sometimes
  • Often
  • Every meeting I attended
Q05
Ranking

Rank these company values by how consistently you see them show up in everyday decisions, from most to least consistent. (Template note: replace with your organization's actual stated values before launching.)

  1. (Value A - e.g. Customer obsession)
  2. (Value B - e.g. Ownership)
  3. (Value C - e.g. Integrity)
  4. (Value D - e.g. Innovation)
  5. (Value E - e.g. Teamwork)
Drag to rank
Q06
Point Allocation

If leadership had 100 points to spend improving our culture this year, how would you allocate them across these areas?

  • Trust & psychological safety
  • Recognition & fair reward
  • Communication & transparency
  • Cross-team collaboration
  • Manager quality & coaching
Allocate 100 points
Q07
Rating ScaleRequired

How well does your immediate manager model the behaviors our company says it values?

Range: 1 – 5
Min:Doesn't model them at allMax:Models them consistently
Q08
AI Interview

Anchor on the respondent's likelihood-to-recommend score and their agreement ratings on speaking up without fear and recognition. If either was low or mid-range, ask for a specific recent moment that shaped that view — what happened, who was involved, and what would have made it feel safer or fairer. If everything scored high, ask what one thing would most put that trust at risk. Push for one concrete example rather than general impressions, and note whether the issue seems tied to their direct manager, a team dynamic, or company-wide leadership.

Q09
Multiple Choice

In the past 6 months, have culture-related reasons (not pay or role) made you seriously consider leaving?

  • Yes, seriously considered it
  • It crossed my mind briefly
  • No, not really
Q10
Message

Now just a few quick background questions to help us spot patterns across teams. All of these are optional.

Q11
Dropdown

Which department or team are you part of?

  • (Replace with Department A)
  • (Replace with Department B)
  • (Replace with Department C)
  • (Replace with Department D)
  • Prefer not to say
Q12
Multiple Choice

How long have you been with the company?

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

Which best describes your role level?

  • Individual contributor
  • People manager
  • Senior leader / executive
  • Prefer not to say
Q14
Message

That's everything — thank you for your candor. Responses are aggregated into a culture report for leadership, and your AI follow-up answer will only be shared as an anonymized theme, never attributed to you.

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

  • Pairs structured measurement (matrix, rating, ranking, constant sum, opinion scale) with an AI follow-up interview that specifically anchors on each respondent's likelihood-to-recommend score and agreement ratings to dig into the moments behind low-trust or low-safety scores
  • Includes a dedicated manager role-modeling rating item and a values-ranking exercise so leadership can see which stated values actually show up day-to-day versus which don't
  • Captures attrition-risk signal directly (whether culture, not pay or role, has prompted job-search behavior in the past 6 months) alongside department, tenure, and role-level breakdowns for pattern analysis
  • Uses conversational chat-message framing to set context and close out the survey, then aggregates everything into an automated report rather than leaving analysis to the buyer

Jotform

Organizational Culture Survey Form Template

A static, ready-to-field form template covering general culture perception questions. It's built on Jotform's broad form-builder platform, so it's easy to customize fields and branding, but it's a generic form rather than a purpose-built research instrument for trust/psychological-safety measurement.

What it does well

  • Quick to deploy and customize using Jotform's drag-and-drop builder
  • Familiar, low-friction form format for respondents
  • Broad platform integrations typical of Jotform's ecosystem

Where it falls short

  • No adaptive follow-up questioning — respondents answer the same fixed fields regardless of their scores
  • No AI-driven interview or probing to surface the specific moments behind a low score
  • No published methodology or automated culture-specific reporting layer

QuestionPro

Organizational Culture Assessment Survey Template

A structured culture-assessment template from an established enterprise survey platform, likely including standard Likert-style culture items and QuestionPro's own analytics/reporting dashboards. It's a solid fielding-ready survey, but it functions as a fixed questionnaire rather than an interview that adapts to each respondent's answers.

What it does well

  • Backed by a mature enterprise survey platform with dashboarding and analytics
  • Likely includes benchmarking or industry-standard culture question sets
  • Supports large-scale distribution typical of QuestionPro's toolset

Where it falls short

  • No adaptive AI follow-up interview to probe why a respondent gave a specific trust or safety score
  • No voice-based interview option
  • No transparent, published prompt-level methodology for how follow-up questions would be generated

SurveyMonkey

Organizational Culture Survey Template

A recognizable, easy-to-launch culture survey template from a mainstream survey platform, suitable for quick pulse checks. It relies on standard closed-ended question types and SurveyMonkey's built-in reporting, without any mechanism to dig deeper into individual low-trust responses.

What it does well

  • Very quick to launch given SurveyMonkey's simple builder and wide familiarity
  • Built-in basic analytics and reporting
  • Easy distribution across email/link channels

Where it falls short

  • Static question set with no adaptive probing based on individual responses
  • No AI or voice interview component to surface qualitative context behind scores
  • No per-response quality scoring or transparent methodology disclosure

SurveySparrow

360 Culture Assessment Survey

A conversational-style survey template that likely presents questions one at a time in SurveySparrow's chat-like UI, giving it a friendlier respondent experience than a traditional grid form. It's framed as a 360-style assessment, but the conversational format is scripted, not an adaptive AI interview that reacts to what a respondent actually said.

What it does well

  • Conversational, chat-style question flow that can feel more engaging than a traditional form
  • 360-style framing suggests multi-angle culture questions
  • Mobile-friendly presentation typical of SurveySparrow's product

Where it falls short

  • Conversational UI is scripted, not an AI-driven interview that adapts follow-up questions to each answer
  • No voice AI interview option
  • No published per-response quality scoring or prompt transparency

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