Nursing Home Employee Satisfaction Form
Date: [Month Day, Year]
Please answer all questions honestly. No personal information will be disclosed.
Full Name: | [Name] |
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Department: | |
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Email Address: | |
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Phone Number: | |
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Survey Questions
Please rate the following statements on a scale from 1 (Strongly Disagree) to 5 (Strongly Agree).
Statement | 1 | 2 | 3 | 4 | 5 |
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I feel welcomed and valued in my workplace. | | | | | ✔ |
My workplace promotes a culture of respect. | | | | | |
I have the resources needed to perform my job. | | | | | |
My job responsibilities are clear and manageable. | | | | | |
I receive recognition for my work. | | | | | |
My work gives me a sense of accomplishment. | | | | | |
I trust my supervisor/manager. | | | | | |
Communication from management is clear. | | | | | |
There are opportunities for professional growth. | | | | | |
I am encouraged to pursue further training. | | | | | |
Feedback provided to me is constructive. | | | | | |
Open-Ended Questions:
What do you enjoy most about working at [Your Company Name]?
I am satisfied with the balance between my work and personal life. |
What changes would you suggest to improve the workplace?
Any additional comments or concerns you would like to share?
Employee Signature:
[Name]
[Job Title]
[Month Day, Year]
Thank you for participating. Your feedback is invaluable and will be used to improve our workplace.
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