Employee burnout syndrome questionnaire template


Please take a few minutes of your time to fill in the following survey

1. Are you satisfied with your job?

  • Yes
  • Don't know
  • No

2. Do you enjoy your work?

  • Yes
  • Yes, depending on the task
  • Very rarely
  • I have never enjoyed my work

3. Do you feel that you and your work are adequately appreciated?

  • Adequately
  • Sometimes
  • Inadequately

4. Are you beginning to feel complacent at work?

  • Yes
  • No

5. Do you suffer from a sleep disorder of any kind?

  • No
  • I don't know
  • Sometimes
  • Often

6. Do you suffer from any poor health, injury or illness?

  • No

7. Please specify the number of hours per week you spend:

Assign 168 Hours

  • Working

    0 0 168
  • Sleeping or at rest

    0 0 168
  • In leasure or sporting activities

    0 0 168

8. Do you feel you work more than you should?

  • Yes
  • Sometimes
  • No

9. Do you ever feel you have burned-out at work before?

  • Yes
  • No

10. Please specify your gender:

  • Male
  • Female

11. Please specify your age:


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Employee overburden and burnout survey

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You’ll use the employee burnout syndrome questionnaire template primarily to prevent these situations. Discover the causes before the consequences appear.

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The survey sample is ideal for

  • employees in leadership positions,
  • team leaders,
  • HR specialists.

Stressful situations in the workplace are not uncommon and can be triggered by a number of factors. Long-term dissatisfaction at work, low motivation, but also health problems or imbalance of work and personal life. The burnout syndrome questionnaire is a suitable tool for examining the work ethic of staff and manifestations that may indicate a potential risk. Focus on prevention, create a healthy atmosphere in your company and pay attention to the satisfaction of your employees.

The questionnaire template can be fully edited. Survio will process your answers into well-arranged tables and graphs.

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