Measure Your Workplace DEI Climate Effectively

Collect anonymous employee feedback on diversity, equity, and inclusion with this comprehensive DEI climate survey template for organizations.

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Workplace Diversity, Equity & Inclusion Climate Survey

Department

Tenure at This Organization

Role Level

Submit

The Workplace Diversity, Equity & Inclusion Climate Survey template helps HR leaders, DEI officers, and organizational leaders gather candid, anonymous employee feedback on belonging, fairness, and inclusion across all levels of the organization. It covers key dimensions including demographic background, personal identity, bias experiences, and perceptions of equitable opportunity.

Designed for companies of all sizes, this template surfaces critical trends across departments, tenure groups, and role levels — enabling data-driven decisions rather than guesswork. Questions assess everything from manager inclusivity and psychological safety to hiring fairness and employees' willingness to recommend the organization as an inclusive workplace.

Built with anonymity and trust in mind, this form ensures respondents feel safe sharing honest experiences. Use the collected insights to benchmark your current DEI climate, identify gaps, prioritize focus areas, and track progress over time — all with a ready-to-use form you can deploy in minutes.

3 Pages

18 Questions

~6min To complete

Free No credit card needed

Field types Likert Scale ×6 Dropdown ×3 Single Choice ×3 Long Text ×3 Multiple Choice ranking NPS Score

Questions in this template

Free template

The exact questions included — customize any of them to fit your needs.

Page 1 About You 5 questions

Demographics & Background

Your responses are completely anonymous. Demographic information is used only to identify trends across groups and will never be used to identify individuals.

1 Department * Dropdown

2 Tenure at This Organization * Dropdown

3 Role Level * Dropdown

4 Do you identify as a member of an underrepresented or marginalized group? Single Choice

5 Which dimensions of diversity are most relevant to your personal identity? (Select all that apply) Multiple Choice

Page 2 Perceptions of DEI Climate 8 questions

Your Experience with Diversity, Equity & Inclusion

Please rate your level of agreement with each statement based on your day-to-day experience at this organization.

1 I feel I belong and am valued as a member of this organization * Likert Scale

2 People of all backgrounds have equal opportunities for advancement here * Likert Scale

3 My manager actively fosters an inclusive team environment * Likert Scale

4 I can express my authentic self at work without fear of negative consequences * Likert Scale

5 The organization takes meaningful action on DEI, beyond surface-level statements * Likert Scale

6 Hiring and recruitment practices here are fair and unbiased * Likert Scale

7 Have you personally witnessed or experienced discrimination, bias, or microaggressions at this organization in the past 12 months? * Single Choice

8 If you experienced or witnessed an incident, did you feel comfortable reporting it? Single Choice

Page 3 Open Feedback & Priorities 5 questions

Your Voice Matters

1 Please rank the following DEI focus areas by importance to you * ranking

2 How likely are you to recommend this organization as an inclusive place to work? * NPS Score

3 What is one thing this organization does well regarding diversity, equity, and inclusion? Long Text

4 What is one change that would most improve the DEI climate here? Long Text

5 Is there anything else you would like leadership to know about your experience? Long Text

How to use this template

Click "Use This Template Free" to open it in the FormBuilder editor. From there you can add, remove, or reorder fields with drag-and-drop, switch themes for instant restyling, add your logo, configure email notifications, and set your success message. When ready, publish with a unique link and start collecting responses immediately.