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NESS Behavior Consulting's
DIVERSITY & INCLUSION FORM
First name
Last name
What is your job title?
In what year did you start working for this company?
What is your ethnicity?
Choose an option
overall attitude
Employees with different ethnicities and cultures are welcomed in the organization
Strongly Dissagreed
Disagreed
Neutral
Agreed
Strongly Agreed
All employees in the organization are treated equally
Strongly Dissagreed
Disagreed
Neutral
Agreed
Strongly Agreed
I feel valued in the organization
Strongly Dissagreed
Disagreed
Neutral
Agreed
Strongly Agreed
Employees with disabilities are treated equally
Strongly Dissagreed
Disagreed
Neutral
Agreed
Strongly Agreed
All employees have equal access to the opportunities in the organization
Poor
Fair
Good
Very good
Excellent
Prospective employees with different backgrounds are encouraged to apply for positions
Poor
Fair
Good
Very good
Excellent
Career Development
Every employee has a career path that they aware of
Strongly Dissagreed
Disagreed
Neutral
Agreed
Strongly Agreed
Every employee from different culture and ethnicity are treated equally when it is about the promotion
Strongly Dissagreed
Disagreed
Neutral
Agreed
Strongly Agreed
Employees are promoted equally based on their performance and skillset
Strongly Dissagreed
Disagreed
Neutral
Agreed
Strongly Agreed
Harassment and Discrimination
I would report if I experience discrimination and harassment
Strongly Dissagreed
Disagreed
Neutral
Agreed
Strongly Agreed
I know where to register to report discrimination and harassment
Strongly Dissagreed
Disagreed
Neutral
Agreed
Strongly Agreed
I would report if I experience discrimination and harassment
Strongly Dissagreed
Disagreed
Neutral
Agreed
Strongly Agreed
I am confident management would take action if there is any diversification in the organization
Strongly Dissagreed
Disagreed
Neutral
Agreed
Strongly Agreed
Please rate manager's attitude towards D&I
Supportive
Poor
Fair
Good
Very good
Excellent
Appreciative
Poor
Fair
Good
Very good
Excellent
Committed
Poor
Fair
Good
Very good
Excellent
Being aware of D&I in the organization
Poor
Fair
Good
Very good
Excellent
Understanding
Poor
Fair
Good
Very good
Excellent
How satisfied are you about the organization in overall by regarding D&I?
Poor
Fair
Good
Very good
Excellent
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