1. Age: 2. Gender : Male/ Female 3. Designation: 4. Nature of Organisation: 5. Experience: 6. Level in management a. Junior level b. Middle level c.

Senior level

7. How many days in a week you normally work: a. Less than 5 days b. 5 days c. 6 days d. 7 days

8. How many hours in a week you normally work: a. 7-8 hours b.8-9 hours c. 9-10 hours d.10-12 hours e. more than 12 hours

9. How many hours a day do you spend while travelling to work: a.> 30 min b. nearly 1 hour c. nearly 2 hours d. <2 hours

10. How often do you think or worry about work (when you are not actually at work or traveling to work)? a) Never think 11. Do you work in shifts: a. General shift/day shift 12. Are you married: a. Yes 13. If yes, is your spouse employed: a. Yes 14. Do you have children? a. Yes, No. of children b. No b. No b. No b. Night Shift c. Alternative shift b) Rarely c) Sometimes d) Often e) Always

15. Being and employed women who takes care of your children: a. Spouse b. In-Laws c. Parents d. Servants e. baby care centres

16. From the following tick/underline the factor that motivates you to work. a. Personal satisfaction b. Financial independence c. Support from family d. Utilization of time

e. Others (please specify) 17. How do you feel about the amount of time you spent at work: a. Very unhappy b. Unhappy c. Indifferent d. Happy e. Very happy

18. Do you ever feel tired or depressed about your work: a. Never b. Rarely c. Sometime d. Often e. Always 19. Do you ever miss out on any quality time with your family or your friends because of pressure of work? a. Never b. Rarely c. Sometime d. Often e. Always 20. Is your ability to achieve your desired balance between work and life ever a source of personal stress, worry or ill health? ___________ 21. When you want to can you easily take time off to attend home events like school sports days and birthdays etc.? a. Never b. Rarely c. Sometime d. Often e. Always 22. Do you have the time and energy to fulfill your responsibilities outside of work to your satisfaction? a. Never b. Rarely c. Sometime d. Often e. Always 23. Does your partner or children ever complain that you dont have enough quality time for them? a. Never b. Rarely c. Sometime d. Often e. Always 24. How do you manage stress arising from your work? a.Yoga B. Meditation c. Entertainment (specify_______) e. Others (specify_______) 25. Does your company have a separate policy for work life? a. Yes ( specify____________________________________________________) b. No 26. How the following factors hinder or affect you in balancing your work and family commitments? Factors Never Rarely Sometime Often Always

Hours of work Overtime Need to work on holiday Work from home after office hours Travelling away from home Negative attitude of supervisors Negative attitude of colleagues Negative attitude of spouse/ family 27. Do you suffer from any stress related disease?

a. Hypertension b. Obesity c. Diabetes d. Frequent headache e. None f. Others (specify__________) 28. Do you feel work life balance policy in the organization should be customized to individual needs? a. Strongly agree b. Agree c. Indifferent d. Disagree e. Strongly disagree 29. Rank according to their importance the following factors which will help you in your work-life balance: Factors Rank More flexible working hours Work from home Time off for family emergency & events Job sharing Support from superior and colleagues Support from family and spouses 30. Do you think a better work life balance of employees can make the organization more effective and successful?