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You are invited to participate in our survey [Project Description Here]. In this survey, approximately [Approximate Respondents] people will be asked to complete a survey that asks questions about [General Survey Process]. It will take approximately [Approximate Time] minutes to complete the questionnaire.

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How far do you travel to work each day roundtrip?
 
0-15 miles
 
16-30 miles
 
31-50 miles
 
50+ miles
 
 
 
What is your average total commute time per day roundtrip?
 
Under 30 minutes
 
30-45 minutes
 
45-60 minutes
 
60-90 minutes
 
90-120 minutes
 
more than 120 minutes
 
 
 
At what time of day do you begin work most days?
 
Before 8 a.m.
 
8:00-8:30 a.m.
 
8:30-9:00 a.m.
 
9:00-9:30 a.m.
 
9:30 a.m. or after
 
 
 
Are you able to achieve a balance in your personal and work life?
 
Yes
 
No
 
Somewhat
 
 
 
Which alternative work schedule appeals to you most?
 
8 am to 4:30 pm- Monday through Friday
 
7:30 am to 4:00 pm- Monday through Friday
 
9 am to 5:30 pm- Monday through Friday
 
9 hr day, 9 days, 10th day off
 
4 ten hour days with three days off
 
Other
 
 
 
 
Have you taken any sick days this year that you can attribute to burnout?
 
Yes
 
No
 
 
 
What are the main reasons you'd prefer an alternative work schedule. Please select all that apply.
 
Arrangements for family/child care
 
Allows time for school
 
Nature of the job
 
Personal Preference
 
Other
 

 
 
 
Which do you value most?
 
Salary
 
Work hours
 
Vacation/Sick Time
 
Benefits
 
Other
 
 
 
 
Which do you value most?
 
Salary
 
Work hours
 
Vacation/Sick Time
 
Benefits
 
Other