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Workplace Diversity, Equity & Inclusion Climate Survey

Measures how included, respected, and fairly treated employees feel day-to-day — covering belonging, fairness in advancement, exposure to exclusionary behavior, and which DEI investments matter most. An AI follow-up interview turns the lowest-scoring signals into concrete, specific stories HR can act on. For HR and DEI teams running an annual or pulse climate check, about 8 minutes.

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Sample questions

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

16 questions · ~8 min
Q01
Message

Thanks for taking a few minutes for our workplace inclusion check-in. Your honest answers help us understand what's working and what isn't — all responses are confidential and used in aggregate. About 8 minutes.

Q02
Opinion ScaleRequired

I feel a genuine sense of belonging on my team.

Scale: 1 – 7
Min:Strongly disagreeMax:Strongly agree
Q03
MatrixRequired

How much do you agree or disagree with each statement about your workplace?

5 rows × 5 columns
  • People from different backgrounds are treated fairly on my team.
  • Leadership demonstrates genuine commitment to diversity and inclusion.
  • I can express my authentic self at work without fear of negative consequences.
  • Decisions about pay, promotions, and assignments are made fairly regardless of background.
  • My team actively seeks out and includes diverse perspectives when making decisions.
Columns: Strongly disagree · Disagree · Neutral · Agree · Strongly agree
Q04
Multiple ChoiceRequired

In the last 6 months, have you witnessed or experienced behavior at work that made someone feel excluded or disrespected because of their identity (e.g., race, gender, age, disability, sexual orientation)?

  • No
  • Yes, I witnessed it happen to someone else
  • Yes, I experienced it myself
  • Yes, both — I've witnessed and experienced it
Q05
Rating ScaleRequired

How fair do you believe access to promotions and career advancement is at this company, regardless of someone's background?

Range: 1 – 5
Min:Not fair at allMax:Completely fair
Q06
Best–Worst Trade-off (MaxDiff)Required

Which of these should the company prioritize improving first?

  • Hiring practices that broaden the candidate pool
  • Manager accountability for inclusive behavior
  • Pay and promotion equity
  • Employee resource groups and community building
  • Flexible work arrangements for diverse needs
  • Training on unconscious bias and inclusive leadership
  • Transparent communication about diversity goals and progress
Pick best & worst per setBest:Most important to improveWorst:Least important to improve
Q07
Multiple Choice

Which of the following diversity, equity, and inclusion resources have you used in the past year?

  • Employee resource groups (ERGs)
  • Mentorship or sponsorship programs
  • Bias or inclusion training
  • Anonymous reporting channel for discrimination or harassment
  • Manager or HR conversations about inclusion
Q08
AI Interview

Explore the story behind this person's sense of belonging score and their answer about witnessing or experiencing exclusionary behavior. If they reported exclusion, ask for a specific recent example — what happened, who was involved, how (or whether) it was addressed, and what would have made them feel supported. If they scored belonging highly, probe what specifically makes them feel included so it can be reinforced elsewhere. Do not ask them to name individuals; keep the focus on situations and systems.

Q09
Opinion ScaleRequired

How likely are you to recommend this company to a friend from an underrepresented background as a place where they'd be treated fairly and included?

Scale: 0 – 10
Min:Not at all likelyMax:Extremely likely
Q10
Message

Just a few optional background questions to help us see patterns across groups — feel free to skip any of these.

Q11
Multiple Choice

What is your gender identity?

  • Woman
  • Man
  • Non-binary
  • Prefer not to say
Q12
Multiple Choice

How would you describe your race or ethnicity?

  • Black or African American
  • East Asian
  • South Asian
  • Hispanic or Latino/a/x
  • Middle Eastern or North African
  • Native American or Indigenous
  • White
  • Two or more races or ethnicities
  • Prefer not to say
Q13
Multiple Choice

What is your age range?

  • Under 25
  • 25–34
  • 35–44
  • 45–54
  • 55–64
  • 65 or older
  • Prefer not to say
Q14
Multiple Choice

Do you identify as a person with a disability?

  • Yes
  • No
  • Prefer not to say
Q15
Multiple Choice

How long have you worked at this company?

  • Less than 1 year
  • 1–2 years
  • 3–5 years
  • 6–10 years
  • More than 10 years
  • Prefer not to say
Q16
Message

Thank you for your honesty. Your responses are combined with your colleagues' anonymously and shared with HR leadership to shape our inclusion action plan — no individual answers are ever identified.

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 turns the lowest belonging or fairness scores into concrete, specific stories HR can act on, rather than leaving low scores unexplained.
  • Combines quantitative measures (opinion scale, matrix, rating, max-diff prioritization) with qualitative depth in a single ~8-minute flow, so teams get both the 'what' and the 'why' without running a separate follow-up study.
  • Includes a dedicated max-diff question so leaders know which DEI investments to prioritize first, not just how people feel generally.
  • Transparent, auto-generated reporting turns raw responses into HR-ready output, and optional voice AI interviewing is available for teams who want richer verbal disclosure on sensitive topics.

Jotform

Questionnaire for Equity & Managing Diversity at workplace Form Template

A static, fillable form template for gathering equity and diversity feedback, built on Jotform's general-purpose form builder. It's fielding-ready for basic data collection but is a fixed question set rather than an adaptive interview instrument. Best suited to teams wanting a quick, customizable form rather than deeper narrative insight.

What it does well

  • Easy to customize within Jotform's drag-and-drop form builder
  • Fielding-ready template that can be deployed quickly
  • Familiar form format for respondents

Where it falls short

  • No adaptive follow-up questioning — every respondent sees the same fixed question set
  • No mechanism to turn low scores into detailed qualitative stories
  • No published methodology or automated quality scoring of responses

QuestionPro

Workplace diversity survey template

A workplace diversity survey template from a full-featured survey platform with strong analytics and reporting tooling. It's a static questionnaire structure, well-suited to standard climate tracking, but doesn't probe further when a respondent flags a problem area. Good for benchmarking over time but not for surfacing rich individual context.

What it does well

  • Backed by a mature survey platform with robust reporting and analytics dashboards
  • Template designed specifically for workplace diversity tracking
  • Supports repeatable, benchmarkable fielding for annual/pulse checks

Where it falls short

  • Fixed question set with no adaptive AI probing on low-scoring responses
  • No optional voice interview mode for richer verbal disclosure
  • No transparent, published prompt-level methodology

SurveySparrow

Workplace Diversity Questionnaire Template

A conversational-style survey template that presents questions one at a time for a friendlier respondent experience. The conversational UI improves completion feel but doesn't equate to adaptive intelligence — questions are pre-set, not generated based on a respondent's actual answers. Suitable for a pleasant static questionnaire, not for uncovering the story behind a low score.

What it does well

  • Conversational, one-question-at-a-time interface that may improve completion rates
  • Purpose-built diversity questionnaire template
  • Mobile-friendly presentation

Where it falls short

  • No true adaptive AI follow-up — the conversational format is presentational, not response-driven
  • No automated per-response quality scoring
  • No voice AI interview option for deeper disclosure

Typeform

Diversity and Inclusion Survey Template

Typeform's D&I template offers a polished, conversational-feeling survey experience with its signature single-question screens. It's a fixed template that can be customized before fielding but does not adapt content based on individual answers. Well suited to a clean, on-brand survey experience rather than adaptive qualitative discovery.

What it does well

  • Polished, well-branded single-question interface known for high completion rates
  • Easy to customize visually before fielding
  • Established template used broadly for D&I feedback

Where it falls short

  • No adaptive follow-up interviewing tied to low or concerning scores
  • No automated quality scoring of individual responses
  • No transparent prompt methodology or optional voice interview mode

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