Confidential EEO Employee Survey
General Information
Department
Job Title
Demographic Information
Gender
Male
Female
Other
Prefer not to answer
Ethnicity
Hispanic or Latino
White (Not Hispanic or Latino)
Black or African American (Not Hispanic or Latino)
Native Hawaiian or Other Pacific Islander
Asian
American Indian or Alaska Native
Two or More Races
Prefer not to answer
Disability Status
I have a disability
I do not have a disability
Prefer not to answer
Veteran Status
Veteran
Not a Veteran
Prefer not to answer
Experience & Feedback
Do you feel included and respected at work?
Always
Usually
Sometimes
Rarely
Never
Have you experienced discrimination or bias at work?
Yes
No
Not sure
Prefer not to answer
Additional Comments or Suggestions