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WORKPLACE WELLNESS SCORECARDGarth Jensen2024-05-28T15:01:09-04:00

WORKPLACE WELLNESS SCORECARD

Organizational Demographics
Workplace Environment
Policies and Practices
Leadership Commitment
Health Promotion
Benefits Metrics

Organizational Demographics

GENERAL DETAILS
Name(s)*
Email*
Organization*
Industry
Who referred you to this Scorecard? (ie. Benefit Consultant's name)
Head office city/location*
Number of locations or branches
Number of employees*
EMPLOYEE CHARACTERISTICS
(Please state in % or #, stay consistent in your answers)
Males
Females
18-34 Age Group
Please indicate the number of employees within each of the following age categories:
35-44 Age Group
45-54 Age Group
55-64 Age Group
Over 65 Age Group
WORK STATUS
Please specify the number of employees in each of the following work status categories:
Full-time hourly employees
Full-time salary employees
Part-time employees
Temporary employees
Casual employees
Student employees
LOCATION BREAKDOWN
Please specify the number of employees in each of the following work locations:
Onsite
(working exclusively at the physical office location)
Remote
(working exclusively from a location outside the office, such as from home or another remote location)
Hybrid
(working both onsite and remotely on a regular basis)
Do employees have access to a company email address?
Yes - all employees
Yes - some employee
No employees
SCHEDULES
Please provide information about your work schedule and operating hours:
What is your typical workday schedule? (Select one)
One day shift (e.g. 8 AM to 4 PM, 9 AM to 5 PM)
More than one shift (Please specify)
Please specify if second option.
Please specify if third option.
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Workplace Environment

Name*
Email*
Organization*
WORKPLACE ENVIRONMENT
Which of the following amenities or resources does your workplace offer or provide access to? *
Please select all that apply.
None of the below
An onsite cafeteria offering healthy food choices
Bicycle racks or designated storage areas
Dedicated change rooms
Easily accessible stairwells
Ergonomic workstations
Properly lit workstations/areas
Shower facilities for employees
Vending machines stocked with healthy options
Wellness stations or a resource library
Workstations designed with ergonomics in mind
Does your workplace provide any of the following spaces or facilities for various activities? *
Please select all that apply.
None of the below
Accessible areas for walking
Areas designated for on-site exercise classes
Boardrooms
Company grounds / outdoor spaces
Grounds for cycling
Kitchenettes
Lunchrooms
Meeting rooms
Quiet spaces / pods
Spaces suitable for workshops
Staff rooms
Trails or paths
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Policies and Practices

Name*
Email*
Organization*
POLICIES AND PRACTICES
Is the treatment of employees with respect and dignity explicitly documented as part of your organizational and departmental values?*
Yes
No
Do employees regularly undergo performance reviews, and if so, do they receive constructive performance feedback?*
Yes
No
Is flexible work time (flex time) an option that employees can access in your organization?*
Yes
No
Does your organization offer the option for employees to work from home?*
Yes
No
Does your company provide a wellness spending account for its employees?*
Yes
No
Are there employee wellness programs offered during company time?*
Yes
No
If business travel is required for certain roles, does your organization encourage weekday-only travel for those employees?*
Yes
No
N/A
Does your organization maintain written policies for any of the following?*
Please select all that apply.
None of the below
Drugs and alcohol in the workplace
Health and safety
Healthy eating
Mental health and well-being
Physical activity
Smoking in the workplace
Stress in the workplace
Work-life balance (e.g. flexible working, ‘family-friendly’ practices)
Workplace conduct and interpersonal relationships (e.g. cultural awareness, respect, and the prevention of bullying)
How does the organization handle corporate advertising or sponsorship related to food, drink, fitness, and sports within the workplace?
How much time is allocated for other breaks during the employees' working day?
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Leadership Commitment

Name*
Email*
Organization*
MEETINGS - Specify the frequency of the staff meetings (e.g. weekly, monthly, quarterly, etc.):
Leadership Meetings*
All-staff Townhalls*
Frequency
Other meeting schedule (Specify the type and frequency)
Frequency
Other meeting schedule (Specify the type and frequency)
LEADERSHIP COMMITMENT
Does the organization have a mission or vision statement?*
Yes
No
Does your organizational mission or vision statement incorporate and support the importance of employee health?*
Yes
No
N/A
Do senior leaders in your organization prioritize the creation of a healthy workplace?*
Yes
No
Is the importance of a healthy culture and healthy lifestyle covered in a new employee orientation?*
Yes
No
In which of the following aspects of employee wellness do middle managers and supervisors actively participate:
None of the below
Active involvement in the Wellness Committee
Actively promoting employee wellness, such as encouraging stretch breaks and providing healthy snacks in lunchrooms
Actively participating in wellness initiatives within the organization
Serving as healthy role models for employees
Please share any goals and objectives that the leadership team considers important and has included in the organizational strategic plan for the upcoming year(s).
Has the leadership team established a strategic plan for the organization?*
Yes
No
Does this strategic plan specifically include workplace wellness?*
Yes
No
Please specify the three primary objectives for your workplace wellness/health promotion program.
Wellness Program Objectives*
We currently do not have any objectives identified. .
We have objectives identified.
1st Objective
2nd Objective
3rd Objective
Please outline the top three long-term wellness goals to be achieved within the next 2-4 years.
Do you currently have any goals (long-term or short-term)? *
Yes, listed below
No
1st Long-term Goal
2nd Long-term Goal
3rd Long-term Goal
Please share any additional information or details you would like to provide regarding your current workplace wellness program.
Please identify the top three short-term wellness goals to be achieved within the next year?
1st Short-term Goal
2nd Short-term Goal
3rd Short-term Goal
What is the current annual budget for wellness initiatives/programs?*
< $5000
$5000-10000
$10000-$25000
> $25000
Who within the organization oversees the approval of new programs and budgets related to employee wellness?
Name(s) / position
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Health Promotion

Name*
Email*
Organization*
HEALTH PROMOTION
Please indicate whether your workplace wellness program has engaged in the following activities and initiatives. *
Please select all that apply:
None of the below.
Allocated an annual budget for workplace wellness
Conducted an employee needs and interests survey
Conducted evaluation measures to assess the program
Conducted a health risk assessment for employees
Created an overview or health promotion plan or calendar
Employed a Workplace Wellness Coordinator
Established an identity for the workplace wellness program, including a name, mission, and vision (4)
Maintained an active Workplace Wellness Committee
Offered incentives for participation in wellness offerings
Provided some health promotion programs for employees' families
Supported health initiatives in the community that encourage employee participation and volunteer efforts
Utilized employee success stories/testimonials in program marketing
Please select the communication and marketing channels utilized within your workplace to promote activities. *
Please select all that apply:
None of the below.
E-mail
E-bulletin boards
Employee/Corporate newsletter
Internal mail system
Leadership Updates
Media screens
Notice boards
Payslip flyers
Printed displays/signs
Staff meetings
Staff room notices
Training sessions
Voicemail
Weekly e-notices
Other (please specify)
Please select the health promotion categories that have been included in your workplace wellness program over the past two years. *
Please select all that apply:
None of the below
Chronic disease management
Financial wellness
Health screenings
Healthy culture
Healthy environment (e.g. ergonomics, workspace design, natural lighting)
Health risk assessments
Mental health and wellness
Nutrition
Physical health and fitness
Social Connection
Smoking cessation
Stress management
Work-life balance
Other (please specify)
Please indicate the AWARENESS-based initiatives that have been promoted within your workplace over the past two years. *
Please select all that apply:
None of the below
Activity days (e.g., Bell Let’s Talk, Blue Monday)
Active stretch breaks
Brochures, videos, posters, pamphlets, newsletters, or other written or online information addressing the benefits of a healthy lifestyle
Health Fair
Lunchtime walks
Promotion of health at meetings, such as providing healthy food options, oxygen breaks, and limiting sitting to encourage standing
Promotion of wellness program events and initiatives at staff meetings
Promotional signs at elevators, stairwell entrances or exits, and other key locations encouraging employees to use the stairs
Walking meetings
Wellness challenges (individual or team-based)
Wellness portal (e.g. intranet, website)
Other (please specify)
Please indicate the PARTICIPATION-based initiatives that your workplace has promoted within the last two years.*
Please select all that apply:
None of the below
Active team-building events
Company leagues or ladders
Corporate challenges
Group wellness sessions (education workshops, lunch n’ learns, seminars)
Inter-company and/or cross-company competitions
Lunchtime activity groups
On-site activity classes
On-site group exercise classes
Participation in local or national events
Recreational games for employees at lunchtime or after work
Sports or activity clubs
Team wellness challenges
Other (please specify)
Please indicate the ENGAGEMENT-based initiatives that your workplace has promoted within the last two years. *
Please select all that apply:
None of the below
Biometric screening
CPR/First Aid Training
Employee Assistance Program (EAP) or Employee and Family Assistance Program (EFAP)
Fitness assessment
Flu shot clinic
Health risk assessment
Individual Health Coaching
Mental Health First Aid
Mental health training and awareness for employees
Mental health training and awareness for managers
Mental health training and awareness for senior leaders
On-site fitness facility
Smoking cessation offering
Subsidize or discount the cost of on-site or off-site exercise facilities
Other (please specify)
Which wellness initiatives implemented in the last two years have been the most positively received and successful, and what factors do you believe contributed to their success?
What have been the most significant challenges encountered within your wellness program over the past two years, and what factors do you believe have contributed to these challenges?
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Benefits Metrics

Name*
Email*
Organization*
Drug Classifications
Do you have access to your Drug Classifications data?*
Yes, listed below
No
#1 Drug Classification*
# of Incidences for #1*
#2 Drug Classification
# of Incidences for #2
#3 Drug Classification
# of Incidences for #3
#4 Drug Classification
# of Incidences for #4
#5 Drug Classification
# of Incidences for #5
Absenteeism Rate*
(Average number of sick days per employee per year)
This field should be left blank

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