WellAwareness - Baseline Assessment for Organizations

WellAwareness - Baseline Assessment for Organizations

Workplace Performance & Resilience Programme
(Internal Corporate Qualification & Baseline Assessment—WellAwareness)

Purpose:
This form helps organizations assess current workplace performance, resilience capacity, and well-being indicators before engaging in the program. It allows both the employer and program team to identify opportunities for performance optimization, risk prevention, and measurable impact.
Company Name*
Industry/Sector*
Number of Employees (Approx.)*
Number of Employees (Approx.)*
Contact Person Name*
Contact Person Role*
Contact Person Email*
example@example.com
Contact Person Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Preferred Programme Timeline
Overall employee stress levels (estimate):*

LowModerateElevatedHigh
Burnout risk indicators currently observed:*

Frequent fatigue or disengagementIncreased absenteeismDeclining focus/productivityWorkplace tension or morale concernsNot currently observed
Productivity and focus levels (overall perception):*

1

2

3

4

5

6

7

8

9

10

1 is 1 (Very Low), 10 is 10 (Very High)
Physical discomfort patterns affecting work:*

Postural pain / desk-related strainRepetitive stress or fatigueNo significant issues reportedUnsure
Primary reason for considering this program:*

Stress management supportBurnout preventionProductivity improvementEmployee retention & engagementWorkplace culture enhancementPreventive wellbeing strategy
Current well-being initiatives in place (if any):
Areas where performance could improve most:*

Focus and efficiencyEnergy and resilienceCommunication/moraleLeadership resilienceOverall workplace wellbeing
Leadership support level for wellbeing initiatives:*

StrongModerateLimited
Openness of employees to wellbeing programs:*

HighModerateUncertain
Desired measurable outcomes:*

Reduced stress indicatorsImproved productivityBetter employee retentionEnhanced workplace cultureLong-term preventive health focus
Is workplace wellbeing currently part of your strategic priorities?*

YesExploringNot yet
What would success look like after a program?
Any specific organizational concerns or goals we should understand?
Should be Empty: