Q01
Message
All templatesIndustry-Specific
Workplace Gender Discrimination Climate Survey
Measures how often employees experience or witness gender-based discrimination — in pay, promotion, meetings, and everyday treatment — and how safe they feel speaking up. An AI follow-up interview reconstructs a specific incident in the respondent's own words, revealing what actually happened and what response would have felt fair, for HR and DEI teams benchmarking climate and prioritizing fixes.
Sample questions
A preview of what’s in the template. Every question is editable before you launch.
15 questions · ~8 min
Q02
Multiple ChoiceRequired
In the last 12 months, have you personally experienced or witnessed gender-based discrimination at work?
- Yes, I experienced it personally
- Yes, I witnessed it happen to someone else
- Both experienced and witnessed it
- No, neither
- Prefer not to say
Q03
MatrixRequired
In the last 12 months, how often have you experienced each of the following at work?
5 rows × 5 columns
- Being passed over for a promotion or a high-visibility assignment
- Receiving unequal pay or benefits for comparable work
- Being excluded from key meetings or decisions
- Hearing dismissive or stereotyping comments about your gender
- Experiencing unwanted comments or advances of a sexual nature
Columns: Never · Rarely · Sometimes · Often · Very often
Q04
Opinion ScaleRequired
How safe do you feel raising a concern about gender discrimination at work without fear of retaliation?
Scale: 1 – 7
Min:Not safe at allMax:Completely safe
Q05
Multiple Choice
Have you ever reported a gender discrimination incident at work, formally or informally?
- Yes, and I was satisfied with the outcome
- Yes, but I was not satisfied with the outcome
- No, I considered it but decided not to
- No, I haven't had an incident to report
- Prefer not to say
Q06
AI Interview
Reconstruct the most significant gender discrimination incident the respondent experienced or witnessed in the last 12 months: what happened, who was involved, whether it was reported, and how it was handled. If they never reported it, probe what specifically held them back. If they rated psychological safety low, anchor on what would need to change for them to feel safe speaking up. If they said 'No, neither' to the first question, ask what makes their team or manager an exception worth learning from.
Q07
Best–Worst Trade-off (MaxDiff)Required
Which of these organizational changes would most improve gender equity at your workplace? Pick the most and least impactful each round.
- Transparent, published pay bands for every role
- Structured, criteria-based promotion decisions
- Mandatory training on discrimination and bystander intervention
- An anonymous, trusted incident reporting channel
- Sponsorship or mentorship programs for underrepresented groups
- Leadership accountability tied to diversity metrics
- Flexible parental and caregiving leave policies
- Diverse interview and hiring panels
Pick best & worst per setBest:Most impactfulWorst:Least impactful
Q08
Rating ScaleRequired
How effectively does leadership in your organization model inclusive, non-discriminatory behavior?
Range: 1 – 5
Min:Not effectively at allMax:Extremely effectively
Q09
Opinion Scale
How likely are you to look for a new job in the next 12 months because of how gender issues are handled here?
Scale: 0 – 10
Min:Not at all likelyMax:Extremely likely
Q10
Message
Almost done — just a few optional background questions to help us spot patterns across teams.
Q11
Multiple Choice
What is your gender identity?
- Woman
- Man
- Non-binary
- Prefer not to say
Q12
Dropdown
What is your age range?
- Under 25
- 25-34
- 35-44
- 45-54
- 55-64
- 65 or older
- Prefer not to say
Q13
Multiple Choice
Which best describes your role level?
- Individual contributor
- People manager
- Senior or executive leadership
- Prefer not to say
Q14
Multiple Choice
Which department or function do you work in?
- Sales & Marketing
- Operations
- Engineering or Technical
- Finance, Legal, or HR
- Customer Support
- Prefer not to say
Q15
Message
Thank you for trusting us with this. Your answers are combined with others (never shared individually with your manager) to shape training, policy, and reporting improvements — we'll share a summary of what we change as a result.
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 a dedicated multiple-choice and matrix section covering pay, promotion, meetings, and everyday treatment, so climate is measured across multiple discrimination vectors rather than a single generic question
- Pairs quantitative screening (frequency matrix, safety-to-speak-up opinion scale, reporting history) with an AI follow-up interview that reconstructs the respondent's most significant incident in their own words, capturing what happened and what response would have felt fair
- Adds a MaxDiff prioritization question and a leadership-inclusiveness rating so HR/DEI teams get both diagnostic detail and a ranked list of fixes, not just prevalence stats
- Closes with optional demographic questions (gender identity, age range, role level, department) explicitly framed for pattern-spotting, plus a stated confidentiality/aggregation commitment to respondents
QuestionPro
Gender Discrimination Survey Questions + Sample Questionnaire TemplateThis page reads primarily as a sample question bank and guide rather than a single fielding-ready survey flow, aimed at researchers assembling their own instrument. It covers common discrimination topics (pay, promotion, treatment) in a static question-list format. Useful as a reference but requires manual assembly before it can be deployed.
What it does well
- Broad library of pre-written sample questions covering multiple discrimination dimensions
- Backed by an established survey research platform with customization and distribution tools
- Likely offers logic/branching capabilities typical of QuestionPro's builder
Where it falls short
- Presented as a static question set/guide rather than a ready-to-send survey experience
- No adaptive follow-up that probes a specific incident in the respondent's own words
- No automated per-response quality scoring or transparent AI methodology disclosed
SurveyMonkey
Gender In The Workplace Survey TemplateA ready-to-use static template focused on workplace gender experiences generally, likely covering perceptions and treatment at a broad level. It benefits from SurveyMonkey's widely used distribution and reporting tools, but it is a fixed-question format rather than a discrimination-climate diagnostic. There is no indication it isolates specific incident detail or safety-to-report metrics in depth.
What it does well
- Fielding-ready template with SurveyMonkey's established distribution and dashboard reporting
- Simple, quick-to-launch format familiar to most respondents
- Likely benchmarkable against SurveyMonkey's own template norms
Where it falls short
- Fixed-choice questions only — no adaptive AI interview to reconstruct a specific incident
- No mechanism to capture what a 'fair response' would have looked like from the respondent's perspective
- No published prompt-level transparency or automated quality scoring of responses
Jotform
Gender Equality Survey Form TemplateA no-code form template centered on gender equality broadly, which overlaps with but is not identical to a discrimination-climate-specific survey — it likely emphasizes attitudes and equality perceptions rather than incident-level detail. It's easy to customize visually via Jotform's drag-and-drop builder and integrates with Jotform's broader form ecosystem. As a static form, it is best suited for simple data collection rather than deep qualitative follow-up.
What it does well
- Easy drag-and-drop customization and branding via Jotform's form builder
- Integrates with Jotform's wider suite of apps, notifications, and storage tools
- Simple, fast to deploy for basic equality-perception polling
Where it falls short
- Static form fields only — no adaptive AI follow-up interview or voice interview option
- No structured incident reconstruction or fairness-of-response capture
- No automated quality scoring or transparent AI prompt disclosure
Frequently asked questions
What questions are in the “Workplace Gender Discrimination Climate Survey” template?
The template includes 15 ready-to-use questions, starting with: “Thanks for taking a few minutes on this. We're asking about experiences with gender discrimination at work so we can ide…” · “In the last 12 months, have you personally experienced or witnessed gender-based discrimination at work?” · “In the last 12 months, how often have you experienced each of the following at work?”. The full set is previewed above, and every question is editable.
How long does this survey take to complete?
Respondents typically finish the 15 questions in about 8 minutes.
Can I customize this template?
Yes — every question, answer option, and the ordering is editable before you launch. You can add or remove questions, or ask the AI editor to rework the survey around your research goal.
Is this template free to use?
Yes. Open it in the editor and start customizing right away — no account required to try it, and the free plan covers launching your survey.
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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