Many businesses have a goal of being a more diverse and inclusive employer but how do you know if your efforts are working? One of the ways to know if your business is becoming more diverse is to regularly measure the diversity of your staff.
The format and questions of the example survey below might help you pull together your own survey.
Example Survey
The collection of self-identification data enhances our understanding of the diversity of our team and supports our commitment to equity and inclusion. The questions are primarily based on the current standard used by Statistics Canada in census questionnaires, and wording from the Employment Equity Act and Accessible Canada Act.
The questionnaire covers five dimensions: age, gender identity, Indigenous identity, visible minority identity, and disability identity. Individuals can and should self-identify in all groups that apply to them. If you do not want to self-identify, you have the option to choose “I prefer not to answer” for each question. The survey also includes a separate question providing staff the opportunity to self-identify as neurodivergent.
Answers are anonymous.
Please complete the survey below.
I was born:
- After 1996
- Between 1977- 1995
- Between 1965 – 1976
- Between 1946 – 1964
- Before 1945
- I prefer not to answer
Select the option that best describes your gender identity:
- Non-binary and/or Two-Spirit
- Man
- Transman
- Transwoman
- Woman
- I don’t identify with any option provided
- I prefer not to answer
Do you identify as Indigenous; that is First Nations (North American Indian), Métis, or Inuk (Inuit)?
- Yes
- No
- I prefer not to answer
If “Yes”, select the options that you identify with:
- First Nations
- Inuit
- Métis
- I prefer not to answer
Do you identify as a person with a disability as described in the Accessible Canada Act?
Note: The Accessible Canada Act defines disability as “any impairment, including a physical, mental, intellectual, cognitive, learning, communication or sensory impairment-or a functional limitation-whether permanent, temporary or episodic in nature, or evident or not, that in interaction with a barrier, hinders a person’s full and equal participation in society.”
- Yes
- No
- I prefer not to answer
If “Yes”, select the types of disability that applies to you:
- Communications
- Developmental
- Dexterity
- Flexibility
- Hearing
- Learning
- Memory
- Mental-health related
- Mobility
- Pain-related
- Seeing
- Disability not listed above.
- I prefer not to answer
- Specify (If you click this option a text box will open)
Do you identify as a member of a visible minority in Canada?
Note: Visible minority refers to whether a person belongs to a visible minority group as defined by the Employment Equity Act and, if so, the visible minority group to which the person belongs. The Employment Equity Act defines visible minorities as “persons, other than Aboriginal peoples, who are non-Caucasian in race or non-white in colour.”
- Yes
- No
- I prefer not to answer
If “Yes”, select the options that you identify with:
- Arab
- Black
- Chinese
- Filipino
- Japanese
- Korean
- Latin American
- South Asian (e.g., East Indian, Pakistani, Sri Lankan, etc.)
- Southeast Asian (including Vietnamese, Cambodian, Laotian, Thai; etc.)
- West Asian (e.g., Iranian, Afghan, etc.)
- Another visible minority group – specify: If you click this option a text box will appear.
If there is a dimension of diversity that you are particularly interested in you can add a questions. For example an organization interested in neuodivergence might ask:
Do you identify as neurodivergent?
- Yes
- No
- Prefer not to say