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Worksite health survey
How healthy is your workplace?
Use this easy survey to learn whether your workplace provides employees with healthy surroundings. By filling
out the survey before beginning your program, and again when your program ends, you’ll be able to see
where you made progress.
Health environment and policies
Before
program l✔
After
program l✔
Yes No Yes No
Senior leadership encourages managers/supervisors to actively support wellness
efforts and sets an example for healthy lifestyles.
l l l l
We have a company wellness plan. l l l l
We have an employee or team dedicated to health and wellness issues. l l l l
We have a budget for health and wellness activities. l l l l
Stairs are well lit, safe, and accessible to employees. l l l l
We have a tobacco-free environment/campus policy. l l l l
Our workplace complies with all OSHA regulations and ergonomic guidelines. l l l l
Health and wellness support is included in our health plan(s). l l l l
Nutrition

Before
program l✔
After
program l✔
Yes No Yes No
We offer targeted programming or resources around eating well. l l l l
Healthy snacks are available at the workplace (e.g., in vending machines). l l l l
Company-provided meals include healthy options (cafeterias, catered meetings, etc.). l l l l
A refrigerator is available so that employees can bring healthy lunches from home. l l l l
Healthy eating guidelines are posted in our workplace. l l l l
1 kp.org/choosebetter
Physical activity

Before
program l✔
After
program l✔
Yes No Yes No
We offer targeted programming or resources around physical activity. l l l l
Bike racks are available for employees who ride to work. l l l l
We encourage walking meetings and other fitness activities. l l l l
We provide employee discount rates for gym memberships, physical activity
programs, or team sports.
l l l l
We encourage employees to stretch during the workday. l l l l
Stress management

Before
program l✔
After
program l✔
Yes No Yes No
We offer targeted programming or resources around stress management. l l l l
We encourage employees to take breaks during the workday. l l l l
We have an employee assistance program and promote it to employees. l l l l
Our health plan(s) offer(s) stress-reduction assistance. l l l l
A list of stress warning signs is posted in our workplace. l l l l
We plan “stress-busting” events during high-stress times for our company. l l l l
Prevention

Before
program l✔
After
program l✔
Yes No Yes No
Our health plan(s) recommend(s) preventive screenings. l l l l
We encourage employees to complete a Total Health Assessment. l l l l
Our health plan(s) offer(s) lifestyle management programs (e.g., weight loss support
groups, telephonic coaching, etc.).
l l l l
Our workplace has safety training and/or a safety committee l l l l
We sponsor first aid and CPR training for the employee who volunteers to be our
safety officer.
l l l l
2 kp.org/choosebetter
Communications

Before
program l✔
After
program l✔
Yes No Yes No
We assessed our employees’ physical working environment, job locations, and job
functions to determine an effective communications strategy (e.g., the percentage
with regular computer access to the intranet).
l l l l
We surveyed our employees and understand their preferred methods for employee
wellness communications (email, direct mail, payroll stuffers, social media platforms,
intranet, etc.).
l l l l
We assessed our employee population language needs as part of our
communications strategy.
l l l l
kp.org/choosebetter
Business Marketing Communications 60229517 July 2014
3

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Worksite Health Survey

  • 1. Worksite health survey How healthy is your workplace? Use this easy survey to learn whether your workplace provides employees with healthy surroundings. By filling out the survey before beginning your program, and again when your program ends, you’ll be able to see where you made progress. Health environment and policies Before program l✔ After program l✔ Yes No Yes No Senior leadership encourages managers/supervisors to actively support wellness efforts and sets an example for healthy lifestyles. l l l l We have a company wellness plan. l l l l We have an employee or team dedicated to health and wellness issues. l l l l We have a budget for health and wellness activities. l l l l Stairs are well lit, safe, and accessible to employees. l l l l We have a tobacco-free environment/campus policy. l l l l Our workplace complies with all OSHA regulations and ergonomic guidelines. l l l l Health and wellness support is included in our health plan(s). l l l l Nutrition Before program l✔ After program l✔ Yes No Yes No We offer targeted programming or resources around eating well. l l l l Healthy snacks are available at the workplace (e.g., in vending machines). l l l l Company-provided meals include healthy options (cafeterias, catered meetings, etc.). l l l l A refrigerator is available so that employees can bring healthy lunches from home. l l l l Healthy eating guidelines are posted in our workplace. l l l l 1 kp.org/choosebetter
  • 2. Physical activity Before program l✔ After program l✔ Yes No Yes No We offer targeted programming or resources around physical activity. l l l l Bike racks are available for employees who ride to work. l l l l We encourage walking meetings and other fitness activities. l l l l We provide employee discount rates for gym memberships, physical activity programs, or team sports. l l l l We encourage employees to stretch during the workday. l l l l Stress management Before program l✔ After program l✔ Yes No Yes No We offer targeted programming or resources around stress management. l l l l We encourage employees to take breaks during the workday. l l l l We have an employee assistance program and promote it to employees. l l l l Our health plan(s) offer(s) stress-reduction assistance. l l l l A list of stress warning signs is posted in our workplace. l l l l We plan “stress-busting” events during high-stress times for our company. l l l l Prevention Before program l✔ After program l✔ Yes No Yes No Our health plan(s) recommend(s) preventive screenings. l l l l We encourage employees to complete a Total Health Assessment. l l l l Our health plan(s) offer(s) lifestyle management programs (e.g., weight loss support groups, telephonic coaching, etc.). l l l l Our workplace has safety training and/or a safety committee l l l l We sponsor first aid and CPR training for the employee who volunteers to be our safety officer. l l l l 2 kp.org/choosebetter
  • 3. Communications Before program l✔ After program l✔ Yes No Yes No We assessed our employees’ physical working environment, job locations, and job functions to determine an effective communications strategy (e.g., the percentage with regular computer access to the intranet). l l l l We surveyed our employees and understand their preferred methods for employee wellness communications (email, direct mail, payroll stuffers, social media platforms, intranet, etc.). l l l l We assessed our employee population language needs as part of our communications strategy. l l l l kp.org/choosebetter Business Marketing Communications 60229517 July 2014 3