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Employee Burnout Risk Survey
This confidential survey helps identify workplace stress and burnout risks. Please answer honestly based on your recent experience.
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How often have you felt emotionally exhausted by your work?
*
1 = Never, 10 = Very often
1 → Not likely
10 → Highly likely
1
2
3
4
5
6
7
8
9
10
Not likely
Highly likely
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How manageable is your current workload?
*
1 = Completely manageable, 10 = Impossible to manage
1 → Not likely
10 → Highly likely
1
2
3
4
5
6
7
8
9
10
Not likely
Highly likely
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How supported do you feel by your manager and team?
*
1 = Not supported at all, 10 = Extremely supported
1 → Not likely
10 → Highly likely
1
2
3
4
5
6
7
8
9
10
Not likely
Highly likely
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How often do you work beyond your scheduled hours?
*
Never
Rarely
Sometimes
Often
Always
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How well are you able to disconnect from work outside working hours?
*
Very easily
Somewhat easily
Neither easily nor difficultly
Somewhat difficultly
Very difficultly
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How would you describe your current energy level at work?
*
Very high
High
Moderate
Low
Very low
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What are the main factors contributing to your stress or fatigue at work?
/
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What changes would help reduce your risk of burnout?
/
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Would you like someone from the appropriate support team to follow up with you?
*
Yes
No
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