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Warehouse Collaborative Robot Safety Survey Template

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?
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?
Q5
rating
How confident are you that current procedures help maintain safety around cobots?
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?
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).
Q14
numeric
What minimum distance (meters) do you prefer between you and a moving cobot in shared aisles?
Q15
long text
Anything else we should know about working safely with cobots?
Max 600 chars
Q16
dropdown
What is your age?
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?
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?
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 Interview
Q24
chat message
Thank you for completing the survey! Your feedback will help improve safe, effective work with cobots.

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Warehouse Collaborative Robot Safety Survey Template - Survey Template | QuestionPunk