Title Page
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Prepared by
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Location
Attitudes Towards Diversity and Inclusion
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The organization shows a clear commitment to diversity, inclusion, and equity.
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The organization creates an environment for free and open expression of ideas, opinions, and beliefs.
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The upper-level management team shows a clear commitment to diversity, inclusion, and equity.
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My manager shows a clear commitment to diversity, inclusion, and equity.
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Employees of all cultures and backgrounds feel valued and respected in this organization.
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I feel included and respected.
Belonging
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I feel that I belong in this organization.
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I feel free to be myself at this organization.
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The organization and my team value my contributions.
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I am recognized for my accomplishments at this organization.
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I feel included in communications about important information.
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When I speak up at work, my opinion is valued.
Recruitment and Advancement
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The organization recruits and hires employees from diverse backgrounds.
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The organization is fair in its hiring and promotion practices.
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Advancement and professional development opportunities are fairly given to all staff.
Discrimination and Harassment
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I know where and how to report concerns about discrimination and/or harassment.
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The organization takes appropriate action in response to incidents of discrimination and/or harassment.
Sign Off
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Name and Signature