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Sample Sukhi Questionnaire

Email:
Employer (option):
What age group do you belong to?
18-24 years old
25-34 years old
35-44 years old
45-54 years old
55-64 years old
65+ years old
Which Organizational Area does your role fall under?
Finance
Human Resources
IT
Sales
Customer Services
Legal
Marketing/Communication
Facilities
Other
Please Specify:
Is English your primary language?
Yes
No
Other
Please Specify:
How do you describe your race/ethnicity? (check all that apply)
African American or Black
African National
Caribbean Islander
East Asian or East Asian American
South Asian or South Asian American
Caucasian, White, or European
American Hispanic or Latino/Latina
Middle Eastern
American Native, Alaskan Native, Pacific Islander
Prefer Not to Answer
Other
Please Specify:
How do you describe your gender identity? (check only one)
Male
Female
Prefer Not to Answer
Other
Please Specify:
 
For the following questions regarding community, assume community is defined as the people you collaborate closest to or whom are the most supportive of your growth. 
 
 
A sense of community with my peers is important to me.
Strongly Disagree
Disagree
Agree
Strongly Agree
I feel valued by this community.
Strongly Disagree
Disagree
Agree
Strongly Agree
Fitting into this community is important to me.
Strongly Disagree
Disagree
Agree
Strongly Agree
Overall, I am satisfied with my current role as an employee/student.
Strongly Disagree
Disagree
Agree
Strongly Agree
My supervisor/professors, or some other leader/faculty, seem to care about me as a person
Strongly Disagree
Disagree
Agree
Strongly Agree
The mission or purpose of my work/study makes me feel my role is important.
Strongly Disagree
Disagree
Agree
Strongly Agree
I am able to bounce back quickly when faced with adversity.
Strongly Disagree
Disagree
Agree
Strongly Agree
I don't avoid conflict.
Strongly Disagree
Disagree
Agree
Strongly Agree
I influence where I can rather than worry about what I can't influence.
Strongly Disagree
Disagree
Agree
Strongly Agree
Thinking about the future gives me anxiety.
Strongly Disagree
Disagree
Agree
Strongly Agree
I am able to stop myself from ruminating over past events.
Strongly Disagree
Disagree
Agree
Strongly Agree
I am able to forgive others without holding a grudge.
Strongly Disagree
Disagree
Agree
Strongly Agree
I take time for myself daily.
Strongly Disagree
Disagree
Agree
Strongly Agree
I attend to my health and hygiene needs regularly.
Strongly Disagree
Disagree
Agree
Strongly Agree
I take vacation days off work without feeling guilty.
Strongly Disagree
Disagree
Agree
Strongly Agree
When I feel stressed, I am able to express it to others who can help me.
Strongly Disagree
Disagree
Agree
Strongly Agree
I am able to identify my emotions.
Strongly Disagree
Disagree
Agree
Strongly Agree
My emotions are easily influenced by my manager's behavior.
Strongly Disagree
Disagree
Agree
Strongly Agree
I am able to be myself with my peers without worry of being judged.
Strongly Disagree
Disagree
Agree
Strongly Agree
When a peer shares something with me in confidence, I feel it is a burden.
Strongly Disagree
Disagree
Agree
Strongly Agree
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