Racism survey template helps organizations collect data on racism and racial discrimination. Use this free template to ask employees about personal experiences, incidents, perceptions, and the impact on work and wellbeing.

The template contains targeted multiple‑choice questions covering frequency of incidents (Never, Sometimes, Usually, Always), types of negative treatment (bullying, gossip, insults, physical violence), unfair task distribution, guidance and feedback, mobbing, and more. Several items include an Other option for open responses. It also supports Likert scales, demographic fields, and anonymous responses to protect privacy.

Designed for HR, diversity, equity and inclusion teams, managers, and researchers, this survey fits internal climate assessments, incident reporting, training evaluation, and monitoring progress on workplace inclusion. It captures concerns about psychological and physical safety, unequal pay and career opportunities, and interpersonal relations.

Click "Use This Template" to customize branding, add questions, and start collecting confidential responses online and integrate with HR systems and analytics.