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* 1. What is today's date?

Date

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* 2. Select one of the following programs

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* 3. I work at the following location:

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* 4. My workload is manageable.

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* 5. The overall training and education I receive is relevant to my job and needs.

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* 6. I receive recognition and positive reinforcement for my work.

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* 7. I am satisfied with my pay compared with the pay for similar jobs in like agencies or organizations.

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* 8. I feel my supervisor is a competent manager.

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* 9. My supervisor has awareness and understanding of problems within the workplace.

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* 10. My supervisor conducts helpful and informative reviews of my performance.

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* 11. My co-workers are pleasant and helpful.

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* 12. The general morale of my co-workers is positive.

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* 13. I am satisfied with the overall leadership of the organization.

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* 14. I am satisfied with the way leadership communicates policies, procedures, and directives to employees.

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* 15. The organization treats all employees fairly, consistently, and respectfully.

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* 16. I am able to communicate with my supervisor on a weekly or as needed basis.

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* 17. I receive adequate information on agency policies during orientation from Human Resources.

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* 18. I receive adequate information on agency policies, programs, projects and procedures from my supervisor.

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* 19. The physical working conditions are adequate.

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* 20. I am satisfied with the opportunities for career development.

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* 21. The vacation and sick leave policies are satisfactory.

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* 22. The medical, dental, vision, life, and retirement plans are satisfactory.

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* 23. I am satisfied with this organization as a place to work.

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* 24. How long have you been employed by the agency?

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* 25. Comments:

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