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Employee Work-Life Balance Assessment

Measures how well employees are able to separate work from personal life, where the biggest pressure points come from (workload, schedule unpredictability, always-on culture), and how supported they feel by managers. The AI follow-up digs into the single most disruptive factor each person names, surfacing a concrete recent example instead of a vague complaint.

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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 a few minutes for this check-in on work-life balance. Your honest answers help us fix real problems, not just track a score. About 5-6 minutes, and individual responses stay confidential.

Q02
Multiple ChoiceRequired

In the last 30 days, how often did you work outside your scheduled hours (evenings, weekends, or on days off)?

  • Never
  • Rarely (1-2 times)
  • Sometimes (about weekly)
  • Often (several times a week)
  • Almost always
Q03
Opinion ScaleRequired

Overall, how satisfied are you with your current work-life balance?

Scale: 1 – 7
Min:Very dissatisfiedMax:Very satisfied
Q04
MatrixRequired

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

5 rows × 5 columns
  • I can disconnect from work messages during personal time without guilt
  • My workload is manageable within my scheduled hours
  • My manager respects my time off
  • I feel comfortable taking time off when I need it
  • My schedule is predictable enough to plan my personal life
Columns: Strongly disagree · Disagree · Neutral · Agree · Strongly agree
Q05
Best–Worst Trade-off (MaxDiff)Required

Which of these has the biggest effect on your work-life balance, and which has the least?

  • Total volume of work
  • Unpredictable schedule or last-minute changes
  • Always-on messaging culture
  • Limited or hard-to-use paid time off
  • Commute or location demands
  • Caregiving or family responsibilities
  • Unclear expectations from leadership
Pick best & worst per setBest:Biggest effectWorst:Least effect
Q06
Slider MatrixRequired

How much control do you feel you have over each of the following?

4 rows, one slider each
  • Your daily schedule
  • Your total workload
  • Where you work from
  • When you take time off
Slider 0–10Min:No controlMax:Full control
Q07
Number

On average, how many hours do you work in a typical week, including any work done outside scheduled hours?

Q08
Multiple ChoiceRequired

Have you used all of your available paid time off in the last 12 months?

  • Yes, all of it
  • Used most of it
  • Used about half
  • Used very little or none
  • I don't have paid time off
Q09
AI Interview

Ask the respondent to walk through the factor they rated as having the biggest effect on their work-life balance in the previous ranking question, anchored to a specific recent week or incident, not a generalization. Probe what actually happened, what they tried to do about it, and whether their manager or team was aware. If they describe the always-on culture or unpredictable schedule, ask what a realistic fix would look like for their role specifically.

Q10
Opinion ScaleRequired

How likely are you to tell a friend that this is a place where they can maintain a healthy work-life balance?

Scale: 0 – 10
Min:Not at all likelyMax:Extremely likely
Q11
Multiple Choice

Which best describes your role level?

  • Individual contributor
  • Team lead / supervisor
  • Manager
  • Senior leader / executive
  • Prefer not to say
Q12
Multiple Choice

How long have you been with the organization?

  • Less than 1 year
  • 1-3 years
  • 4-7 years
  • 8+ years
  • Prefer not to say
Q13
Multiple Choice

What is your primary work arrangement?

  • Fully on-site
  • Hybrid
  • Fully remote
  • Prefer not to say
Q14
Message

That's everything - thank you for your honesty. Responses are aggregated to identify the biggest drivers of overwork and will guide changes to workload, scheduling, and time-off policies.

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

  • Goes beyond static rating questions with an AI follow-up interview that digs into whichever factor (workload, unpredictable schedule, always-on culture, etc.) each respondent flags as most disruptive, asking them to walk through a concrete recent example instead of leaving it as a vague complaint.
  • Combines quantitative measures (opinion scale on satisfaction, numeric hours worked, matrix and slider-matrix on control/agreement, max-diff to force-rank pressure points) with open-ended probing in a single flow, so you get both the 'what' and the 'why'.
  • Includes context questions on PTO usage, role level, tenure, and work arrangement so pressure points can be segmented by who's actually experiencing them.
  • Transparent prompts and automated per-response quality scoring mean you can see exactly what the AI asked and trust that low-effort or contradictory responses are flagged before they hit your report.

Jotform

Work Life Balance Survey Form Template

A fielding-ready static form template covering standard work-life balance questions. It's built on Jotform's general-purpose form builder, so it's easy to customize fields and branding, but it stops at collecting answers rather than exploring them.

What it does well

  • Fielding-ready out of the box
  • Easy drag-and-drop customization typical of Jotform's builder
  • Can integrate with Jotform's broader form/workflow ecosystem

Where it falls short

  • No adaptive follow-up questioning — respondents can't be probed for specifics behind a vague answer
  • No voice interview option
  • No automated per-response quality scoring or published prompt methodology

SurveyMonkey

Work Life Balance Survey Template & Questions

A ready-to-use survey template with pre-written questions on work-life balance, backed by SurveyMonkey's established analytics and benchmarking tools. It's a solid standard questionnaire but relies on fixed question sets rather than dynamic probing.

What it does well

  • Pre-written, fielding-ready question set
  • Mature analytics/reporting dashboard
  • Wide familiarity among respondents and admins

Where it falls short

  • No AI-driven follow-up that adapts to each respondent's stated biggest pressure point
  • No guided task or screen-share capability
  • No transparent, inspectable AI prompts since there's no AI interview component

Typeform

Employee Work Life Balance Survey Template

A conversational-style, fielding-ready template that uses Typeform's one-question-at-a-time format to make the survey feel more personal. Question flow can include basic logic jumps, but there's no true adaptive AI interviewing that generates a new question based on open-text content.

What it does well

  • Polished, conversational respondent experience
  • Fielding-ready with minimal setup
  • Supports basic conditional logic between questions

Where it falls short

  • Logic jumps are pre-set, not generated live from what the respondent actually says
  • No voice AI interview option
  • No automated quality scoring of individual responses

Ready to launch?

Open this template in the editor. Every part is yours to change before the first respondent sees it.

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