Q01
Long Text
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Wellness Program Engagement & Barriers Survey
Measures employee participation patterns, motivational drivers, and barriers to workplace wellness engagement. Designed for HR and wellness teams seeking actionable data to improve program design, communication, and uptake.
Sample questions
A preview of what’s in the template. Every question is editable before you launch.
24 questions · ~4 min
Q02
Multiple Choice
In the past 90 days, how often did you participate in any workplace wellness program or activity?
Q03
Multiple Choice
What motivates you to participate in wellness programs? Select all that apply.
Q04
Long Text
How likely are you to participate in a wellness program in the next 3 months?
Q05
Multiple Choice
How do you prefer to participate in wellness activities? Choose up to three.
Q06
Long Text
If you could change one thing about your organization's wellness programs to increase your participation, what would it be?
Q07
Multiple Choice
What is your primary work arrangement?
Q08
Long Text
Thank you for completing the survey. Your feedback will directly inform improvements to our wellness programs.
Q09
Multiple Choice
Which types of wellness activities have you participated in during the last 6 months? Select all that apply.
Q10
Multiple Choice
Which factors, if any, made it difficult to participate in wellness programs in the past 90 days? Select all that apply.
Q11
Long Text
Realistically, how many wellness activities do you expect to participate in over the next 3 months?
Q12
Multiple Choice
Which communication channels would most likely prompt you to participate? Select all that apply.
Q13
AI Interview
Based on your survey responses, we'd like to explore your wellness experience in a bit more depth. Please share your thoughts and our AI moderator will ask a couple of brief follow-up questions.
Q14
Multiple Choice
Which best describes your role level?
Q15
Long Text
How clear are you about the wellness programs currently available to you?
Q16
Long Text
How important is it that wellness programs fit into your existing work schedule?
Q17
Long Text
Rank the following incentives from most motivating to least motivating.
Q18
Multiple Choice
How long have you been with your organization?
Q19
Long Text
How important is it that wellness program content is relevant to your personal health goals?
Q20
Long Text
When do you most prefer to participate in wellness activities?
Q21
Long Text
Where are you primarily located?
Q22
Long Text
How important is it that your manager supports your participation in wellness programs?
Q23
Long Text
Rank the following wellness topics by your level of interest (top = most interested).
Q24
Long Text
How important is it that your participation data and health information remain private?
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.
Ready to launch?
Open this template in the editor. Every part is yours to change before the first respondent sees it.