All templates

DEI Pulse: Inclusion, Equity & Belonging Assessment

A 30-day pulse instrument for HR and people teams to measure employees' sense of inclusion, procedural equity, and representation—designed to surface bias gaps, track belonging trends, and prioritize DEI initiatives.

Sample questions

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

19 questions · ~9 min
Q01
Message

Welcome to the DEI Pulse Survey. This short survey asks about your experiences with inclusion, fairness, and belonging at work over the last 30 days. Your participation is completely voluntary, and you may stop at any time. There are no right or wrong answers—we are interested in your honest perceptions. All responses are confidential and will be reported only in aggregate, so no individual can be identified. The results will be used internally to guide workplace improvements. The survey takes approximately 5–7 minutes to complete.

Q02
Opinion Scale

Overall, how included did you feel at work in the last 30 days?

Scale: 17
Min:Not at all includedMax:Completely included
Q03
Opinion Scale

In the last 30 days, policies and rules were applied consistently on my team.

Scale: 17
Min:Strongly disagreeMax:Strongly agree
Q04
Opinion Scale

In the last 30 days, I saw people who share my background or identity represented in leadership and visible roles.

Scale: 17
Min:Strongly disagreeMax:Strongly agree
Q05
Long Text

Based on your responses in this survey, please share any additional thoughts about inclusion, equity, or belonging at work—including what's working well or what could improve.

Q06
Dropdown

How long have you been with the organization?

  • Less than 6 months
  • 6–12 months
  • 1–2 years
  • 3–5 years
  • 6+ years
  • Prefer not to say
Q07
Message

Thank you for completing this survey. Your responses are confidential and will be reported only in aggregate. Your feedback helps shape a more inclusive workplace.

Q08
Opinion Scale

In the last 30 days, I felt safe to speak up and share my ideas at work.

Scale: 17
Min:Strongly disagreeMax:Strongly agree
Q09
Opinion Scale

In the last 30 days, I had fair access to growth and development opportunities.

Scale: 17
Min:Strongly disagreeMax:Strongly agree
Q10
Opinion Scale

When I shared feedback in the last 30 days, I saw evidence that it was acknowledged or acted upon.

Scale: 17
Min:Strongly disagreeMax:Strongly agree
Q11
AI Interview

We'd like to understand your experiences in more depth. Please share a specific situation from the last 30 days related to inclusion, fairness, or belonging at work, and our AI moderator will ask a couple of brief follow-up questions.

Q12
Dropdown

Are you a people manager?

  • Yes
  • No
  • Prefer not to say
Q13
Opinion Scale

In the last 30 days, I felt a sense of belonging on my team.

Scale: 17
Min:Strongly disagreeMax:Strongly agree
Q14
Dropdown

Which process felt least fair to you in the last 30 days, if any?

  • Hiring and selection
  • Pay and compensation
  • Performance reviews
  • Work assignments
  • Scheduling and flexibility
  • Access to tools or resources
  • None of these
  • Prefer not to say
Q15
Ranking

Rank the following areas by where you believe DEI effort should focus most next quarter (1 = highest priority).

  1. Hiring and recruitment practices
  2. Career development and promotion equity
  3. Inclusive team culture and daily interactions
  4. Leadership representation and visibility
  5. Pay equity and transparency
Drag to rank
Q16
Dropdown

What is your primary work arrangement?

  • On-site
  • Hybrid
  • Remote
  • Prefer not to say
Q17
Opinion Scale

In the last 30 days, my unique perspectives and contributions were valued by my colleagues.

Scale: 17
Min:Strongly disagreeMax:Strongly agree
Q18
Dropdown

Which region do you primarily work in?

  • Americas
  • EMEA
  • APAC
  • Other
  • Prefer not to say
Q19
Multiple Choice

In the last 30 days, did you personally experience or witness any of the following at work? (Select all that apply)

  • Interruptions or being talked over
  • Insensitive language or jokes
  • Unequal access to information
  • Bias in decision-making
  • Social exclusion from discussions or events
  • None of the above

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 scales with an AI follow-up interview that asks employees to share a specific example in their own words, then adaptively probes for detail
  • Combines core belonging/inclusion metrics (inclusion, psychological safety, belonging, value of contributions) with procedural equity items (consistency of policy application, fairness of access to growth opportunities)
  • Includes a dropdown to pinpoint which specific process felt least fair, plus a ranking question to prioritize where DEI effort should focus next — turning sentiment into an actionable roadmap
  • Segments results by tenure, manager status, work arrangement, and region via dropdowns, and closes with an open-text reflection question for qualitative context alongside the AI interview

SurveyMonkey

Belonging And Inclusion Survey Template

A fielding-ready static survey template covering belonging and inclusion themes for workplace use. It relies on fixed question sets rather than any adaptive or conversational follow-up, and benefits from SurveyMonkey's broad distribution and dashboard tooling.

What it does well

  • Ready-to-deploy template backed by a well-known, established survey platform
  • Likely benefits from SurveyMonkey's broad distribution channels and standard reporting dashboards
  • Simple format that's easy for HR teams to launch quickly

Where it falls short

  • No adaptive AI follow-up interview to probe deeper into individual experiences
  • No voice AI interview option
  • No published prompt-level methodology or transparency into how any qualitative responses are scored

QuestionPro

Diversity and Inclusion Survey Questionnaire

A structured D&I questionnaire template aimed at HR teams assessing diversity climate. Like most template libraries, it presents a fixed question bank rather than an adaptive interview experience, and QuestionPro is a broader enterprise survey suite rather than an AI-interview-first platform.

What it does well

  • Template designed specifically around diversity and inclusion topics
  • Part of a mature enterprise survey platform with extensive question-type and reporting options
  • Likely customizable within QuestionPro's broader survey builder

Where it falls short

  • Static questionnaire format with no adaptive AI-driven follow-up probing
  • No voice AI interview capability mentioned
  • No automated per-response quality scoring or transparent AI prompt disclosure

Ready to launch?

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