WORK LIFE BALANCE QUESTIONNAIRE

 Age
 Gender
 Experience(years)
 Department

1. How many hours a day you normally work?

 7-8 hours
 8-9 hours
 9-10 hours
 10-12 hours
 More than 12 hours

2. Do you generally feel you are able to balance your work life?
 Yes
 No

3. How often do you think or worry about work (when you are not actually at work or
traveling to work)?
 Never think about work
 Rarely
 Sometimes
 Often
 Always

4. How many hours a day do you spend time with your child/children?
 Less than 2 hours
 2-3 hours
 3-4 hours
 4-5 hours
 More than 5 hours

5. How do you feel about the amount of time you spend at the work?
 Very unhappy
 Unhappy
 Indifferent
 Happy
 Very happy
6. Do you ever miss out any quality time with your family or your friends because of
pressure of work?
 Never
 Rarely
 Sometimes
 Often
 Always
7. Do you ever feel tired or depressed because of work?
 Never
 Rarely
  Sometimes
 Often
 Always

8. How do you manage stress arising from your work?

 Yoga
 Entertainment
 Dance
 Music
 Others, specify_____________________________________________________

9. Do you personally feel any of the following will help you to balance work life?
 Flexible starting hours
 Flexible finishing time
 Flexible hours, in general
 Holidays/paid time offs
 Job sharing
 Career break/sabbaticals
 Time off for family engagement/events
 Others,specify________________________________________________

10. Does your organization provide you with the following additional work provision?
 Telephone for personal use
 Counseling services to the employees
 Health programs
 Parenting or family support programs
 Exercise facilities
 Relocation facilities and choices
 Transportation
 Others,specify____________________________________________

11. Does your organization encourage the involvement of your family members in the
work achievement reward functions?
 Yes, specify the name of such program annual day______________________
 No

12. Does your organization have social functions at times suitable for families?
 Yes, specify the name of such programs____________
 No

13. Do any of he following hinder you in balancing your work and family commitments?
 Long working hours
 Compulsory overtime
 Shift work
 Meetings/ training after office hours
 Others specify____________________________________________________

14. Do any of the following help you balance your work and family commitments?
  Technology like cell phones/lap tops
 Support from colleagues to work
 Support from family members
 Others, specify___________________________________________________

15. Do any of the following hinder you in balancing your work and family commitments?
 Technology such as laptops/cell phones
 Frequently traveling away from home
 Negative attitude of peers and colleagues at work place
 Negative attitude of supervisors
 Negative attitude of family members
 Others specify_____________________________________________________

16. Do you suffer from any stress related disease?

 Hypertension
 Obesity
 Diabetes
 Frequent head aches
 None
 Others specify______________________________________________________
17. Do you get enough time for working out?
 Yes
 No

If yes, how many hours?

 Less than half an hour
 Half an hour
 Half an hour to one hour
 More than one hour

18. What was the last time you lost your temper at work?
 Can’t remember
 Yesterday/today
 More than a week
 Always angry
 More than a month

19. Flexibility to attend events during the workday or shift, such as a child’s school pay,
a medical appointment of an elderly relative or a key sports event is important to many
people to help them with work life balance?
 Strongly agree
 Agree
 Indifferent
 Disagree
 Strongly disagree

20. Do you think that if employees have good work life balance the organization will be
more effective and successful?
 Yes
 no