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Contact Information
First Name : 
Last Name : 
 
 
 
Gender
 
 
 
Age
 
Over 46
 
40 to 45
 
32 to 39
 
25 to 31
 
20 to 24
 
Less than 20
 
 
 
Education Level
 
 
 
Industry
 
Medical
 
Pharmaceutical
 
Nutritionals
 
Vision Care
 
Healthcare Professional
 
Other
 
 
 
 
How many years have you been working with your current employer?
 
Over 7 years
 
5 to 6 years
 
4 to 5 years
 
2 to 3 years
 
Less than 1 year
 
 
 
How many years have you been working with your previous employer?
 
Over 7 years
 
5 to 6 years
 
4 to 5 years
 
2 to 3 years
 
Less than 1 year
 
 
How do you feel about your current working environment?
Strongly Agree Agree Disagree Strongly Disagree
My supervisor or someone at work, seem to care about me as a person
I have a good friend at work
I enjoy coming to work partly because of the people
I get support and encouragement from my team mates
People who challenge the status quo are valued
I feel proud working with the current company
 
 
 
Strongly Agree Agree Disagree Strongly Disagree
It is important that I work for a company that allows me to use my skills and talent
I like to do things which give me a sense of personal achievement
I am most fulfilled in my work when I feel that I have complete financial and employment security
 
 
 
Strongly Agree Agree Neither Agree nor Disagree Disagree Strongly Disagree
If choosing tasks, I want the job that allows me to be recognised for success
I feel that my superior always recognises the work done by me
I work harder on a project if company wide recognition is attached to it
At work, I am valued for my contribution and my opinions seem to count
 
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