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Employee DEI Pulse: Belonging, Inclusion & Equity

Measures employee perceptions of belonging, psychological safety, fairness, and inclusive practices. Designed for quarterly or monthly pulse deployment with confidential, anonymized responses to inform organizational DEI strategy.

Sample questions

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

25 questions · ~11 min
Q01
Message

<p>Welcome to the Belonging, Inclusion & Equity Pulse Survey.</p><p>This short survey ( 11 minutes) asks about your recent experiences with belonging, fairness, and inclusive practices at work. Your participation is completely voluntary, and you may stop at any time.</p><p><strong>Confidentiality:</strong> Your responses are anonymous and will only be reported in aggregate. No individual responses will be shared with managers or leadership. There are no right or wrong answers—we want your honest perspective.</p><p><strong>Purpose:</strong> Results will be used internally to identify priorities and track progress on our inclusion and equity goals.</p><p>Please click next to begin.</p>

Q02
Opinion Scale

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

Scale: 17
Min:Strongly disagreeMax:Strongly agree
Q03
Opinion Scale

Performance evaluations that affected me in the last 6 months were fair.

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

Thinking about the last 60 days, please indicate your agreement: My manager actively seeks out and values diverse perspectives in team discussions.

Scale: 17
Min:Strongly disagreeMax:Strongly agree
Q05
Opinion Scale

Based on your overall experience in the last 90 days, how likely are you to recommend this organization as an inclusive place to work?

Scale: 010
Min:Not at all likelyMax:Extremely likely
Q06
Message

The following questions help us understand experiences across different groups. All are optional, and responses are reported only in aggregate to protect anonymity.

Q07
Message

Thank you for completing this survey. Your responses are confidential and will be reported only in aggregate. Your feedback directly informs our inclusion and equity priorities. If anything in this survey raised concerns you'd like to discuss, please reach out to [HR contact / Employee Assistance Program].

Q08
Opinion Scale

In the last 30 days, I felt safe to raise concerns or disagreements without fearing negative consequences.

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

In the last 30 days, workload was distributed fairly within my team.

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

In the last 60 days, my colleagues treated me with respect regardless of my background or identity.

Scale: 17
Min:Strongly disagreeMax:Strongly agree
Q11
Long Text

Name one change your team or organization could make in the next month that would help you feel more included.

Q12
Dropdown

What is your primary department or function?

  • Engineering / IT
  • Product
  • Sales
  • Marketing
  • Operations
  • HR / People
  • Finance
  • Customer Support
  • Legal
  • Other
  • Prefer not to say
Q13
Multiple Choice

In the last 3 months, did you experience or witness exclusionary behavior at work?

  • Yes, experienced directly
  • Yes, witnessed
  • No
  • Prefer not to say
Q14
Multiple Choice

Compared with peers in similar roles, how fairly are you rewarded overall (compensation, recognition, and benefits)?

  • Much less fairly
  • Somewhat less fairly
  • About the same
  • Somewhat more fairly
  • Much more fairly
  • Prefer not to say
Q15
Opinion Scale

In the last 60 days, my ideas and contributions were given fair consideration in meetings and decisions.

Scale: 17
Min:Strongly disagreeMax:Strongly agree
Q16
AI Interview

Based on your survey responses, we'd like to explore your experiences with inclusion, fairness, and belonging in a bit more depth. Please share what's most on your mind, and our AI interviewer will ask a couple of follow-up questions.

Q17
Dropdown

How long have you worked at this organization?

  • Less than 6 months
  • 6–12 months
  • 1–2 years
  • 3–5 years
  • 6–10 years
  • More than 10 years
  • Prefer not to say
Q18
Long Text

If you experienced or witnessed exclusionary behavior, please briefly describe the situation. Avoid including names or identifying details.

Q19
Multiple Choice

In the last 6 months, which of the following have you experienced regarding access to growth opportunities? (Select all that apply.)

  • I had equal access to high-visibility projects
  • My development or training requests were supported
  • I received mentorship or sponsorship opportunities
  • I lacked access to stretch assignments
  • I was passed over for opportunities without clear reasons
  • Not sure / None of these apply
Q20
Ranking

Rank the following areas from most to least impactful for improving your experience of inclusion.

  1. Manager support and advocacy
  2. Transparent decision-making
  3. Work-life flexibility
  4. Career development and growth paths
  5. Pay equity and recognition
Drag to rank
Q21
Dropdown

What is your current work arrangement?

  • On-site
  • Hybrid
  • Remote
  • Prefer not to say
Q22
Dropdown

Are you a people manager?

  • Yes
  • No
  • Prefer not to say
Q23
Dropdown

What is your primary work location region?

  • Americas
  • EMEA
  • APAC
  • Other
  • Prefer not to say
Q24
Dropdown

How do you describe your gender?

  • Woman
  • Man
  • Non-binary
  • Prefer to self-describe
  • Prefer not to say
Q25
Long Text

If you selected 'Prefer to self-describe,' please share how you describe your gender.

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

  • Includes an AI follow-up interview that adaptively probes respondents' inclusion experiences based on their specific survey answers, rather than a fixed question list
  • Covers belonging, psychological safety, and fairness with dedicated opinion-scale items on evaluations, workload distribution, compensation, and manager inclusive behavior
  • Uses a ranking exercise plus open-text questions so employees can prioritize improvement areas and describe exclusionary incidents or suggested changes in their own words
  • Collects demographic dropdowns (department, tenure, work arrangement, manager status, region, gender with a self-describe option) to enable cross-group equity analysis while keeping responses confidential and anonymized

QuestionPro

Employee pulse sample questionnaire and survey template

A sample questionnaire covering general employee pulse topics (engagement, satisfaction) rather than a DEI/belonging-specific instrument. It's presented as a static question list to adapt manually, backed by QuestionPro's broader survey and analytics platform. Useful as a starting reference but not purpose-built for measuring belonging, fairness, or inclusion.

What it does well

  • Established survey platform with reporting and analytics tools
  • Sample questions can be customized for various pulse survey use cases
  • Backed by a mature enterprise survey feature set

Where it falls short

  • Static questionnaire with no adaptive AI follow-up probing
  • No DEI/belonging-specific question set out of the box
  • No published methodology on how questions were designed or scored

SurveyMonkey

Pulse Survey Template

A general-purpose employee pulse template focused on quick, recurring sentiment checks rather than DEI-specific belonging or fairness measurement. It's a ready-to-deploy static form supported by SurveyMonkey's well-known dashboard and reporting tools. Teams would need to substantially customize it to address inclusion, equity, or exclusionary-behavior topics.

What it does well

  • Simple, quick-to-deploy template with familiar UI
  • Strong built-in reporting and dashboard visualization
  • Wide adoption and easy distribution across teams

Where it falls short

  • No adaptive AI interview or voice AI follow-up capability
  • No automated per-response quality scoring
  • Generic pulse content, not tailored to belonging/equity/fairness dimensions

Ready to launch?

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