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1. What is your age?


2. Gender
a) Male
b) Female

3 Your Designation


4. Do you spend more hours than you would like at work?
a) Yes
b) No

5. Do you spend more hours than you would like working at home?
a) Yes
b) No

If yes, how many hours do you work at home in an average week?
a) 1-4 hours
b) 5-9 hours
c) More than 10 hours

6 Are you satisfied with your work life?
a) Yes
b) No

7 Are you living your ideal life?
a) Yes
b) No

Give reason________________________

specify_____________ 9 Do you generally feel that you are able to balance your work & personal life? a) Yes b) No 10. Do you spend time for working out? a) Yes b) No 11. Being employed man/women who are helping to take care of your children? a) Spouse b) In –laws . no of children__________ 14. 8 How many hours a day do you spend traveling to work? a) Less than half an hour b) Nearly one hour c) Nearly two hours d) If others. Is your partner employed? a) Yes b) No 13. Do you have children? a) Yes b) No If yes. Do you work in job shifts? a) General shift b) Night shift c) Alternative 12. Marital status? a) Married b) Unmarried If you are married.

Do you feel tired or depressed because of work? a) Never b) Rarely c) Sometimes d) Always 17. specify 18. c) Parents d) Servants e) Day care centers How many hours in a day do you spend with your child/children? a) Less than 2 hours b) 2-3 hours c) 3-4 hours d) Other. Does your organisation provide you with yearly master health check up? . specify 15. How do you manage stress arising from your work? a) Yoga b) Meditation c) Dance d) Music e) Other. Do you ever miss out quality time with your family or your friends because of work? a) Never b) Rarely c) Sometimes d) Always 16. Do any of the following hinder you in balancing your work & family commitments? a) Long working hours b) Compulsory overtime c) Shift work d) Other. specify________________________ 19.

specify___________ 23. specify___________ 22. a) Yes b) No 20. Do you suffer from any stress-related disease? a) Hypertension b) Diabetes c) Frequent headache d) Other. what are the provisions under the policy? a) flexible start time b) flexible ending time c) holiday d) job sharing e) career break f) flexible hours in general g) others. Do you generally feel any of the following will help you to balance your work life? a) Flexible start time b) Flexible ending time c) Holiday d) Job sharing e) Career break f) Flexible hours in general g) Others. Does your company have a separate policy of work life balance? a) Yes b) No c) Not aware If yes. specify___________ 21. Do you feel work life balance policy in the organisation should be customized to individual needs? a) Strongly agree b) Agree c) Indifference .

specify__________________ 25. Does your organisation provide you with following additional work provisions? a) Counseling services for employees b) Health program c) Exercise facilities d) Transportation e) Others. Do you think that if employees have good work life balance than the organisation will be more effective and successful? a) Yes b) No Give reason______________ . d) Disagree e) Strongly disagree 24.