Free template to collect warehouse worker feedback on cobot safety and training. Identify hazards, boost compliance, and track near misses. 5–7 minutes.
What's Included
AI-Powered Questions
Intelligent follow-up questions based on responses
Automated Analysis
Real-time sentiment and insight detection
Smart Distribution
Target the right audience automatically
Detailed Reports
Comprehensive insights and recommendations
Sample Survey Items
Q1
Multiple Choice
Which best describes cobot use in your facility today?
No cobots in this facility
Piloting or limited trial only
Used in several areas
Used across most areas
Q2
Dropdown
In a typical week, how often do you work near a cobot?
Never
Less than weekly
1–2 days per week
3–5 days per week
Daily (most shifts)
Continuously during shifts
Not sure
Q3
Multiple Choice
Which tasks do cobots assist with in your area? Select all that apply.
Picking or put-wall
Packing or kitting
Palletizing/depalletizing
Mobile transport (AMRs/tuggers)
Sortation
Quality or safety checks
Replenishment
None of these
Q4
Opinion Scale
In the past 30 days, how safe have you felt working near cobots?
Range: 1 – 10
Min: Very unsafeMid: NeutralMax: Very safe
Q5
Rating
How confident are you that current procedures help maintain safety around cobots?
Scale: 11 (star)
Min: Not confidentMax: Very confident
Q6
Multiple Choice
In the last 6 months, have you experienced or witnessed any safety incident involving a cobot?
No incidents
Near miss (no contact)
Minor contact, no injury
Injury requiring first aid
Injury requiring medical attention
Prefer not to say
Not applicable
Q7
Multiple Choice
If an incident occurred, how was it handled?
Formally reported through the safety system
Addressed informally on the floor
Not reported
No incident occurred
Q8
Matrix
How concerned are you about the following situations when working near cobots?
Rows
Very unconcerned
Somewhat unconcerned
Neither concerned nor unconcerned
Somewhat concerned
Very concerned
Cobot speed when people are close
•
•
•
•
•
Proximity detection responsiveness
•
•
•
•
•
Unexpected stops/starts or path changes
•
•
•
•
•
Handover timing for items
•
•
•
•
•
Blind corners and intersections
•
•
•
•
•
Clarity of audible/visual alerts
•
•
•
•
•
Docking/charging movements
•
•
•
•
•
Q9
Multiple Choice
Attention check: To confirm you are paying attention, please select “I am paying attention.”
I am paying attention
I am not paying attention
Q10
Multiple Choice
In the last 12 months, which cobot safety training have you received? Select all that apply.
Intro safety briefing
Hands-on operation with a supervisor
Refresher/update session
Emergency stop and lockout drills
Digital or e-learning module
None
Not sure
Q11
Multiple Choice
Does current cobot-related training meet your needs?
Fully meets my needs
Mostly meets my needs
Partly meets my needs
Does not meet my needs
No training received
Q12
Multiple Choice
Which safety features are active in your work area? Select all that apply.
Speed/force limiting
Accessible emergency stop buttons
Visual beacons or floor lights
Audible alerts
Virtual fences or safe zones (no hard guarding)
Remote pause/stop capability
Interlocked guarding
Not sure
Q13
Ranking
Please rank your top 3 priorities to improve safety around cobots (drag to rank).
Drag to order (top = most important)
More hands-on training time
Slower speeds in shared zones
Clearer floor markings and signage
More predictable cobot routes
Faster emergency stop response
Better handover prompts and timing
Improved visibility at corners
Q14
Numeric
What minimum distance (meters) do you prefer between you and a moving cobot in shared aisles?
Accepts a numeric value
Whole numbers only
Q15
Long Text
Anything else we should know about working safely with cobots?
Max 600 chars
Q16
Dropdown
What is your age?
Under 18
18–24
25–34
35–44
45–54
55–64
65 or older
Prefer not to say
Q17
Multiple Choice
What is your primary role?
Picker/Packer
Material handler/Forklift
Technician/Maintenance
Team lead/Supervisor
Quality/Safety
Other
Prefer not to say
Q18
Dropdown
How long have you worked at this site?
Less than 3 months
3–11 months
1–2 years
3–5 years
More than 5 years
Prefer not to say
Q19
Multiple Choice
Which shift do you mainly work?
Day
Evening
Night
Rotating/Varies
Prefer not to say
Q20
Dropdown
Where is your primary work site located?
North America
South America
Europe
Middle East
Africa
Asia
Oceania
Prefer not to say
Q21
Long Text
Any final comments or suggestions about cobot safety?
Max 600 chars
Q22
Chat Message
Welcome! This survey asks about your work context, perceptions of safety, training, and suggestions. Your responses are anonymous; please answer based on your recent experience.
Q23
AI Interview
AI Interview: 2 Follow-up Questions on your responses about cobot safety
AI InterviewLength: 2Personality: [Object Object]Mode: Fast
Q24
Chat Message
Thank you for completing the survey! Your feedback will help improve safe, effective work with cobots.
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