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Work-Life Balance Survey Template

This work-life balance survey template asks employees about schedule predictability, after-hours contact, time off, and flexibility during the past four weeks. Use the answers to identify working arrangements your team can improve without asking people to explain their private lives.

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Use this work-life balance survey template to understand how work schedules and expectations affect time outside work. It asks about predictability, after-hours contact, time off, and practical flexibility. Create a survey in SurveyLegend that helps your team discuss working arrangements without asking employees to explain their private lives.

When to use this work-life balance survey

Use it when reviewing scheduling practices, communication expectations, or flexible working arrangements. Ask about the previous four weeks so respondents can consider a typical pattern rather than one unusually difficult day. The goal is to improve how work is organized. It is not to diagnose stress, compare family responsibilities, or decide whose personal commitments are most important.

For broader feedback on the employee relationship, use our employee engagement template.

7 questions for your work-life balance survey

Use these 7 questions as a starting point. All fields are optional; choose one answer where choices are listed. Leave an irrelevant open field blank.

Respondent introduction:
Think about the past four weeks and your agreed work schedule. Please focus on working arrangements, not private family or health information. All questions are optional.

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A little feedback. A clearer picture.

Explore this 7-question example at your own pace. Every question is optional.

SurveyLegend demo Question 1 of 7

Work-Life Balance Survey

01 How predictable was your work schedule?

Choose one answer, or skip this question.

02 How often were you expected to respond to work messages outside your agreed working time?

Choose one answer, or skip this question.

03 How easy was it to disconnect from work when your agreed working time ended?

Choose one answer, or skip this question.

04 How easy was it to take time off that had already been agreed?

Choose one answer, or skip this question.

05 How much flexibility did your working arrangements offer when you needed it?

Choose one answer, or skip this question.

06 Which work practice most affected your time outside work?

Share your answer, or skip this question.

07 What change to working arrangements would help you most?

Share your answer, or skip this question.

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How to customize your work-life balance survey

Define agreed working time for different roles, including shifts and on-call arrangements. Make the after-hours question about expected responses rather than every notification someone receives. Explain who can see results and provide a separate route for individual scheduling requests. A team might need a clearer rule about nonurgent messages, while another needs earlier notice of shifts. Keep those possible changes separate from reducing the amount of assigned work. Before sharing widely, try the questions with a few people from the intended audience and clarify anything they interpret differently.

Printable work-life balance survey template

Use this printable work-life balance survey template during a workplace consultation or staff meeting. It includes the same questions and space to write, giving people who prefer paper or are less comfortable online another way to take part. SurveyLegend helps you offer both formats. Tell respondents where to return the completed form and who will review it. Paper answers need a separate review or manual entry process; they are not automatically added to online responses.

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AI prompt for a work-life balance survey

Ask about the working arrangements your team can improve together.

The full prompt below specifies your work-life balance survey, including all 7 questions and response settings. Copy it, register for a free SurveyLegend account, and paste it into SurveyLegend’s AI survey creation tool. Review the result and add your organization’s details before sharing.

Use prompt directly in SurveyLegend

Create a free account, then paste the copied prompt into SurveyLegend.

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Translate boundary concerns into working arrangements

Look at schedule predictability and after-hours expectations together, then review the ease of taking agreed time off. Group suggestions into changes to notice periods, coverage, meetings, or communication rules. Choose actions that managers can control and explain any constraints openly. Do not add the answers into an invented wellness score. If comparing groups, avoid reporting small combinations that could identify a respondent.

Frequently asked questions

Is this a burnout assessment?

No. It collects feedback on work arrangements and boundaries. It does not diagnose a health condition or use a validated clinical scoring system.

Should we ask about family circumstances?

This template does not need those details. Ask which working arrangements help people manage commitments without requiring them to explain personal or family situations.

Can shift-based teams use it?

Yes. Define agreed hours, scheduling notice, and any on-call expectations for that team before sending the survey.

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