Anonymous Employee Survey — Instructions for business owner or HR manager
When planning and implementing a drug-free workplace policy it may be useful to conduct an anonymous employee survey in an effort to determine the extent of drug or alcohol abuse. The survey on the reverse side may be copied (and modified if desired) and distributed to your employees. Each copy of the survey should be attached to a return envelope addressed or routed to the individual conducting the survey (usually the owner, general manager, or HR manager). It is important to stress that this is an anonymous survey and no attempt will be made to identify participants. You can expect that drug and/or alcohol abusers will be less than honest and forthcoming in their responses, but coworkers will respond if they can do so anonymously. The “Comments” section will often be the best indicator of an ongoing drug or alcohol problem within the company. Please contact Drug Free Business with questions or comments about this survey, 1-800-598-3437.
ANONYMOUS SURVEY
(Company Name) is conducting an anonymous survey to determine the extent of drug and/or alcohol use. The results of this survey will aid us in determining if future changes in policy, benefit and compensation packages and employee assistance plans are needed.
Please do not sign your name to this survey.
No one will attempt to identify anyone completing this survey. Please answer the questions honestly and attach any comments or other information that you think is important.
When done, seal in the attached envelope and return to: _______________________________. Please answer the following questions by circling “yes” or “no”: 1. Do you use recreational drugs (other than caffeine and tobacco) during your lunch or work breaks? Yes No
2. Have you ever used recreational drugs either on or off the job while employed at this company? Yes No
3. Have you ever worked while “high” on recreational drugs or alcohol? Yes No
4. Have you ever seen or heard of any drug dealing by co-workers? Yes No
5. Have you ever seen or heard of any recreational drug use on or off the job? Yes No
6. Have you ever seen or heard of any co-worker drinking alcohol on the job? Yes No
7. Have you ever seen or heard of any co-worker being “high” while at work? Yes No
8. Have you ever seen or heard of any co-worker having such a bad hangover that he/she could not do the job safely and effectively? Yes No
9. Does this company allow the use of alcohol or recreational drugs while working? Yes No
10. Does this company have a serious drug or alcohol problem with one or more employees that upper management should know about? Yes No
Comments: (Continue on back of page if necessary)