QUESTIONNAIRE

NAME:............................................

DESIGNATION:..............................................DEPARTMENT:..............................................

Q1. Age Group:

18-25 25-35 36-45 above46

Q2. How many days in a week do you normally work?

a) Less than 5 days

b) 5 days

c) 6 days

d) 7 days

Q3. How many hours in a day do you normally work?

a) 7-8 hours

b) 8-9 hours

c) 9-10 hours

d) 10-12 hours

Q4. Are you married?

a) YES

b) NO

If yes, is your partner employed?

a) YES

b) NO

Q5. Do you have children?

a) YES

b) NO

Q6. Being an employed woman who is helping you to take care of your children?

a) Spouse

b) In-laws

c) Parents

d) Servants

e) Crèche/day care centres

Q7. How many hours in a day do you spend with your child/children?

a) Less than 2 hours

b) 2-3 hours

c) 3-4 hours

d) 4-5 hours

e) More than 5 hours

Q8. Do you regularly meet your child/children teachers to know how your child is

progressing?

a) Once in a week

b) Once in two weeks

c) Once in month

d) Once in 6 months

e) Once in a year.

Q9. Do you take care of:

a) Older people

b) Dependent adults

c) Adults with disabilities

d) Children with disabilities

e) None

Q10. How do you feel about the amount of time you spend at work?

a) Very unhappy

b) Unhappy

c) Indifferent

d) Happy

e) Very happy

Q11. Do you ever miss out any quality time with your family or your friends because of

pressure of work?

a) Never

b) Rarely

c) Sometimes

d) Often

e) Always

Q12. Do you ever feel tired or depressed because of work?

a) Never

b) Rarely

c) Sometimes

d) Often

e) Always

If you feel tired or depressed, according to you what can be the causes for that:

a) Unrealistic deadlines

b) Lack of support from the superiors

c) Task assigned is above the knowledge/skills level

d) Others(specify).........................................................................................................

.................................................................................................................................

.................

Q13. How do you manage stress arising from your work?

a) Yoga

b) Meditation

c) Entertainment

d) Dance

e) Music

f) Nothing

Q14. Does your organization have a separate policy for work-life balance?

a) Yes

b) No

c) Not aware

If, yes what are the provisions under the policy?

a) Flexible starting time

b) Flexible ending time

c) Flexible hours in general

d) Holidays

e) Job sharing

f) Others

(specify).............................................................................................................

Q15. Do you personally feel any of the following will help you to balance your work life?

a) Flexible starting hours

b) Flexible finishing time

c) Flexible hours in general

d) Holidays

e) Job sharing

f) Time off for family engagements/events

g) Others

(specify)..............................................................................................................

Q16. Do any of the following hinder you in balancing your work and family

commitments?

a) Long working hours

b) Compulsory overtime

c) Meeting or training after office hours

d) Others

(specify)...........................................................................................................

Q17. Do you suffer from any stress-related disease?

a) Hypertension

b) Obesity

c) Diabetes

d) Frequent headaches

e) None

f) Others (specify)....................................................................................................

Q18. Do you get enough sleep, exercise and healthy food?

a) YES

b) NO

Q19. Do you think that if employees have good work-life balance the organization will

be more effective and successful?

a) YES

b) NO

SIGNATURE:..............................

DATE:...................................