Return to Work Survey Template

Introduction

A return to work survey is a structured way to hear from employees as teams move back to on-site work. It focuses on the questions that matter most during a reopening: how far people feel safe, protected, informed, and heard. This template covers safety culture and well-being, personal protective equipment and hygiene access, COVID-19 protocols and symptom reporting, pre-return communication, and staff recommendations. The organization's stated aim is to gather feedback that lets leadership make informed, data-driven decisions for a safer and healthier reopening. The survey records who prepared it, the location, and the dates it was conducted, and it uses a consistent five-point scale from Strongly Agree to Strongly Disagree for most agreement statements. Use it to collect reliable insight from the people who know the day to day best, then use that insight to guide your next safety decisions.

What is a return to work survey

A return to work survey asks employees directly about their experience of returning to the workplace. In this template it is made up of 20 items spanning six sections: Return to Work Survey, Employee Information, Workplace Safety & Well-being, Safety Measures & Prevention, COVID-19 Protocols & Communication, and Feedback & Recommendations. Some items are administrative, such as the date conducted, the person who prepared it, the location, instructions, and a signature. The substantive items ask about safety culture, personal safety, PPE availability, hygiene access, symptom reporting, understanding of COVID-19 protocols, the clarity of pre-return communication, noticed safety improvements, and open recommendations. Most agreement statements use the same five-point response scale, so answers can be compared across people and teams.

Why it matters

Reopening a workplace is easier to get right when you know how it actually feels to the people doing the work. A survey turns scattered impressions into a comparable record: whether staff feel the organization cares about their health, safety, and well-being; whether they have felt safe performing their duties over the past week; and whether they would feel confident about someone close to them working there. It also gives you a direct read on practical matters such as whether the PPE people requested actually reached them and whether handwashing stations and sanitizer are conveniently and reliably accessible. Because the template asks standard questions with standard response scales, it surfaces the same signals from every respondent and gives leadership information to act on.

What a good return to work survey covers

A complete survey touches the things that determine whether a return goes well: - **Safety culture and well-being** — how far the organization demonstrably cares about health, safety, and well-being, whether people have felt safe and secure performing their duties, and whether they would feel confident about a loved one working there. - **Safety as a priority** — whether employees would tell friends and family that a safe and healthy work environment is one of the organization's highest priorities. - **PPE and hygiene** — whether people received every piece of PPE they needed and requested, and whether handwashing stations and/or hand sanitizer dispensers are conveniently and reliably accessible throughout their work area. - **Symptom reporting** — whether people would stay home and notify their supervisor immediately if they experienced COVID-19 symptoms such as fever, cough, unexplained fatigue, or loss of taste or smell. - **Protocol understanding** — a self-rating, on a scale of 1 to 10, of how well the person understands the current COVID-19 safety protocols and prevention measures. - **Pre-return communication** — whether the emails, messages, phone calls, and briefings received before returning clearly prepared the person for what to expect. - **Noticed improvements and recommendations** — how many new safety improvements or prevention measures the person has seen since returning, and what they suggest to enhance workplace safety. The template also records department or team, so you can see whether perceptions differ between parts of the organization.

How to carry out the survey

1. **Prepare the survey.** Enter the location, the person preparing it, instructions for respondents, and the date conducted. The template also provides fields for a signature, a finished-at time, and inspection start and end dates. 2. **Explain the purpose.** Tell participants that the survey gathers feedback on workplace safety perceptions, personal well-being, and confidence in health protocols, and that the results will inform decisions about the reopening. 3. **Ask for the respondent's team.** Have each person indicate which department or team they belong to. 4. **Work through the rating items.** Have respondents rate each agreement statement — covering safety culture, personal safety, confidence in protocols, PPE received, hygiene access, symptom reporting, and pre-return communication — on the five-point scale from Strongly Agree to Strongly Disagree, and give the 1-to-10 rating for protocol understanding. 5. **Collect noticed improvements and open feedback.** Ask approximately how many new safety improvements or prevention measures they have noticed since returning, and invite specific recommendations or suggestions to enhance workplace safety measures. 6. **Review the results as a set.** Compare responses across teams and sections, read the open recommendations for themes, and use what you find to guide action. The survey's purpose is to help leadership make informed, data-driven decisions, so treat the results as an input to planning, not an end in themselves.

Frequently Asked Questions

The return to work survey is part of a workplace inspection and compliance checklist. It replaces a snapshot of workplace conditions with structured employee feedback gathered as teams move back to on-site work. The survey records who conducted it, when and where, and then asks staff about how far they feel the organization cares about their health, safety, and well-being, whether they have felt safe performing their duties over the past week, and whether they would feel confident about the safety of someone close to them working there. It also asks participants to confirm the organization treats a safe and healthy work environment as one of its highest priorities.

You receive personal protective equipment and hygiene access status. The survey asks each participant whether they received every piece of PPE they needed and requested (such as masks, gloves, face shields, and hand sanitizer), with responses covering receiving everything needed, some items not being provided, not requesting any PPE, and the question not applying to their role. A separate item asks about convenient and reliable access to handwashing stations and/or hand sanitizer dispensers throughout the work area, scored on a five-point agreement scale.

You capture how well protocols are understood and followed, and how clearly the return was communicated in advance. Employees rate their understanding of the current COVID-19 safety protocols and prevention measures on a scale of 1 to 10, and state whether they would stay home and notify their supervisor immediately if they experienced symptoms of COVID-19 such as fever, cough, unexplained fatigue, or loss of taste or smell. They also assess whether the information and guidance received before returning — emails, messages, phone calls, briefings — clearly prepared them for what to expect.

You invite staff to name the safety improvements they have noticed and to propose changes. One item asks approximately how many new safety improvements or prevention measures they have noticed since returning to the workplace. Another asks for specific recommendations or suggestions to enhance workplace safety measures, framed around the organization's commitment to continuously improving health and safety for employees and their families.

You use the survey as a structured, data-driven input to reopening and ongoing safety decisions. Scores on the well-being, PPE, hygiene, symptom reporting, protocol understanding, pre-return communication, and noticed-improvements questions show where practice and perception diverge, and the open recommendations point to specific fixes. The survey can cover all teams by asking each participant which department or team they are part of, and it records the location, the person who prepared it, and the conducted, start, and end dates so results stay traceable.

Written by

Arne Reis

Founder

Process optimizer with 25 years of expertise, focused on operational excellence in quality, maintenance, EHS, and commissioning. Emphasizes innovative solutions and top-quality standards.

View LinkedIn profile