Wellbeing template

Employee Burnout Risk Survey Template

A screening survey built around the three recognised dimensions of burnout — exhaustion, cynicism and reduced efficacy — plus the workload, control and recovery factors that drive them. Designed to identify at-risk teams, not to diagnose individuals.

16 questions 4 min to complete Quarterly All employees

Use this template free

When to use it

Run it quarterly as standard, and immediately after any sustained crunch period, reorganisation or major launch. Burnout builds over months, so a single reading matters far less than the direction of travel.

The full question set

Copy these as they are, or adapt the wording to your organisation — just keep it identical between waves, because changing a question resets its trend line.

Exhaustion

1.I feel emotionally drained at the end of most working days.1–5 scale
2.I wake up tired at the thought of another day at work.1–5 scale

Recovery

1.I have enough energy left for my life outside work.1–5 scale
2.I can fully switch off from work during evenings and weekends.1–5 scale
3.I feel comfortable taking time off when I need it.1–5 scale
4.Have you taken all the annual leave you are entitled to this year?Yes / No

Cynicism

1.I have become more cynical about the value of my work.1–5 scale
2.I care less about doing a good job than I used to.1–5 scale

Efficacy

1.I feel effective at my job.1–5 scale

Workload

1.My workload is realistic for the hours I am contracted to work.1–5 scale
2.How often do you work outside your normal hours?Options: Never · Occasionally · Weekly · Several times a week · DailyMultiple choice
3.Deadlines set for my team are achievable.1–5 scale

Control

1.I have control over how I prioritise my work.1–5 scale

Manager

1.My manager notices when someone is under too much pressure.1–5 scale

Open

1.What is the biggest source of pressure in your work right now?Open text
2.What would most reduce that pressure?Open text

How to run it well

Be explicit in the intro that this screens teams, not individuals, and that no one will be identified.
Always report at team level or above with a minimum of five responses.
Pair every wave with a named action — measuring burnout without changing workload actively damages trust.
Include a visible link to your employee assistance or mental-health resources on the final screen.
Compare scores against actual hours, on-call rotas and time-off usage where you have that data.

Questions people ask

Can a survey diagnose burnout?

No, and it should not try to. Burnout is a clinical-adjacent condition assessed by professionals. What a survey can do — reliably — is identify which teams show elevated exhaustion and cynicism, so you can change workload and recovery conditions before people reach that point.

Won't asking about burnout make people focus on it?

The evidence points the other way: people already know how they feel, and being asked signals that it is a legitimate topic. The real risk is asking and then doing nothing, which reads as performative and lowers trust more than never asking.

How do we protect anonymity on a sensitive survey like this?

Never report a segment below five responses, do not cross-tabulate small segments (a 'senior women in engineering in Berlin' filter can identify one person), and store no identity against responses. TruePulse enforces the threshold automatically.

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Send this template in five minutes

Load it into TruePulse, import your team, and let automatic reminders and anonymity thresholds do the rest. Free — every feature, every seat.

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