Coronavirus Return-to-Work Assessment Survey

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How comfortable do you feel returning to the office?
Very comfortable

Somewhat comfortable

Neither comfortable nor uncomfortable

Somewhat uncomfortable

Very uncomfortable
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Tell us about your biggest concerns with the idea of returning to a workplace. (Select all that apply)
Getting exposed to the novel coronavirus while traveling to work

Catching the novel coronavirus at my workplace

Unknowingly spreading the virus to co-workers and staff

A decreased flexibility after working from home

Health reasons preventing me from getting back to the office

Arranging for childcare

Leaving family members at home who need assistance

Anything else? (Please specify)
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I trust my organization to take appropriate safety measures before allowing employees to return to our workplace.
Strongly agree

Agree

Somewhat agree

Somewhat disagree

Disagree

Strongly disagree
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Which of the following would make you feel safer if returning to work? (Select all that apply)
Rotating employees through weekdays

Installing desk partitions

Mandatory virus testing for all employees and staff

Requiring employees to install a contact tracing app that notifies you if a colleague has been diagnosed with COVID-19

Limiting outside visitors to the office

Frequent sanitization of office premises

Closing all communal spaces (e.g. gym, game room)

Routine taking of temperature at check-in and check-out

Cafeteria with limited seating

Having a secure care and support for children

Wearing a mask in the office

Getting a vaccine for the virus

Nothing can make me comfortable returning to the office

Something else? (Please specify)
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Which of the following would bother you if you are required to follow it at the office? (Select all that apply)
Routine taking of temperature at check-in and check-out

Getting a vaccine

Clean desk policy

Wearing a mask while working

Limiting the number of employees in a single shift or day

Installing a contract tracing app

Desk partitions

Office environment sanitization

Bringing your own meals

Closing any communal spaces (e.g- gym, game room)

Something else? (Please specify)
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Is there any process or practice that you would like to see continued if returning to work?

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What is your present living status?
Living alone

Living with family

Living with other people (friends, colleagues, etc.)
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Have you been experiencing any of the known symptoms (as per healthcare dept. guidelines) related to the virus in the past seven days?
Yes

No

Not sure
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Please let us know if you have any other questions, comments, or concerns.

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