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1. How happy or unhappy are you with your current role at your job?

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2. At this organization, do you think that women have more, fewer or the same opportunities to advance as men?

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3. Have you ever felt that your gender has played a role in your missing out on any of the following at this organization?

  Yes No
A raise
A promotion
A high-profile assignment

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4. Have you ever faced discrimination, hostility, or microaggressions at this organization due to your gender?

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5. How much of a priority is gender diversity, equity, and inclusion to our CEO or president?

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6. How much of a priority is gender diversity, equity, and inclusion to your direct manager?

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7. How much of a priority is gender diversity, equity, and inclusion to you, yourself?

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8. Thinking about this organization’s efforts to increase gender diversity, equity, and inclusion, should we:

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9. Do you think that workplace programs designed to improve gender diversity, equity, and inclusion (e.g., leadership development, targeted mentorship programs, networking groups for women and gender minorities) are:

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10. Which of the following work support/flexibility programs have you participated in at this organization? (Select all that apply.)

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11. How concerned are you that taking advantage of flexible work arrangements at your job (e.g. paid leave, work-from-home, flextime) might prevent you from achieving your career goals?

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12. If you chose to stop working for six months or more to handle a family matter, do you think it would hurt your position at work a great deal, hurt somewhat, or would it not make much difference?

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13. Do you have any children under 18?

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