HeySurvey survey

Burnout Assessment Survey*

This survey aims to assess your experience with workplace burnout, including its symptoms, causes, and effects. Your feedback will help us better understand common burnout factors and develop effective resources to address them.

How often have you felt emotionally exhausted from your work in the past month?*

This question helps us evaluate the frequency of one of the key symptoms of burnout.

From Never to Always

Back

Which of the following symptoms have you experienced related to burnout?*

Select all that apply, as some symptoms may overlap.

Feeling tired even after adequate rest
Cynicism or detachment from your job
Reduced sense of personal accomplishment
Increased irritability or impatience
Frequent headaches or physical complaints
None of the above

Back

To what extent do you feel supported by your supervisor or manager at work?*

This question measures perceived support, which influences the risk of burnout.

From Not at all supported to Fully supported

Back

What are the primary factors contributing to your feelings of burnout?*

Please describe the main causes, such as workload, lack of recognition, or unclear expectations.

Back

How would you rate your ability to balance work and personal life?*

An imbalance between work and life is a common contributor to burnout.

From Very poor to Excellent

Back

In the last four weeks, how many days have you considered taking time off due to work-related stress?*

This provides insight into the potential severity and impact of burnout symptoms.

One or none
2–5 days
6–10 days
More than 10 days

Back

What strategies, if any, have you used to manage stress or prevent burnout?

Please share specific practices, techniques, or resources you rely on.

Back

Would you be interested in company-provided resources to help manage burnout?*

Identifying resource needs ensures the right support is developed.

Yes
No
Not sure

Back

Please share any additional comments or suggestions about how your organization could better address burnout.

Your insights can guide improvements in workplace wellness initiatives.

Back

Burnout Assessment Survey*

How often have you felt emotionally exhausted from your work in the past month?*

Which of the following symptoms have you experienced related to burnout?*

To what extent do you feel supported by your supervisor or manager at work?*

What are the primary factors contributing to your feelings of burnout?*

How would you rate your ability to balance work and personal life?*

In the last four weeks, how many days have you considered taking time off due to work-related stress?*

What strategies, if any, have you used to manage stress or prevent burnout?

Would you be interested in company-provided resources to help manage burnout?*

Please share any additional comments or suggestions about how your organization could better address burnout.

Thank you for taking a part in this survey.