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Design surveys, run conversational interviews, and get clear insights. Every response stays encrypted.

AI Survey CreationEffortlessly create high-quality, unbiased surveys with AI-powered tools that save time and reduce cost.AI Survey AnalysisUnlock instant, detailed insights from survey data. AI-powered approach, providing thematic and systematic analysis, anomaly detection, and more.Survey MCPConnect BlockSurvey to Claude, Claude Code, and ChatGPT to create, edit, and publish surveys without leaving your AI assistant.Conversational AI SurveysExperience natural conversations with BlockSurvey's AI-driven survey platform. Create dynamic, personalized dialogues that adapt to each respondent, revealing deeper insights.AI Thematic AnalysisSave hours by automating your thematic analysis process. Quickly identify common patterns and insights from qualitative data.AI Sentiment AnalysisLeverage the power of AI to seamlessly identify sentiment polarity in your qualitative research.AI Adaptive QuestioningGet smarter open-ended responses through AI-powered adaptive follow-up questions in your survey.AI Sample Responses GeneratorGet smarter open-ended responses through AI-powered adaptive follow-up questions in your survey.AI Survey MigrationGet smarter open-ended responses through AI-powered adaptive follow-up questions in your survey.Generate Options with AIBoost engagement with AI-crafted choices that make answering easier and more intuitive.Rephrase with AIRefine the question and description wording in your survey with AI-powered rephrasing for better clarity and tone.Data Encoding with AITurn open-ended responses into categorized insights with AI.AI Survey OptimizationImprove your survey quality effortlessly with AI-powered optimization—spot bias, refine question clarity, and increase completion rates.

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Rank OrderRespondents drag and arrange a list of options in their preferred order.Matrix TableAsk multiple related questions in a single grid with shared answer choices.Constant SumRespondents distribute a fixed total (like 100 points) across multiple options.File UploadCollect documents, images, or other files directly from respondents.Net Promoter Score (NPS)Measure how likely respondents are to recommend you on a 0-10 scale.Social VerificationVerify a respondent's identity by linking their social media account.Loop QuestionRepeat a set of questions automatically for each item in a list.Group QuestionBundle related questions together under a single heading or section.A/B Testing Show different versions of a question to different respondents and compare responses.

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Market ResearchBoost your market research with AI-driven surveys that enhance response rates, ensure data privacy, support white label branding, and offer advanced analysis tools.Institutional ResearchCreate AI-powered surveys & assessments to understand your institution's goals for students, faculty & advisors.HealthcareCollect patient feedback securely with HIPAA compliance and end-to-end encryption, earn patient trust.B2B SaaSReplace guesswork with real signals from the buyers who matter, make every decision with confidence.B2C SaaSCollect honest product feedback from your SaaS users, build what they actually need, not what you assume.Healthcare SaaSHIPAA-compliant product feedback and clinical user research, build products clinicians actually want.Mental HealthSecurely conduct mental health assessments with end-to-end encryption, ensuring privacy and comfort for respondents using ready-to-use, privacy-focused templates.Women's HealthcareRun private, encrypted surveys for Femtech and women's health research, get the data women actually share.Digital HealthcarePower your digital health product with AI conversational surveys, collect health data users trust you with.Preventive HealthcareDeploy health risk assessments across your population, catch risks before they become costs.ActivismRun Activism surveys securely with this trusted data collection platform, where Onion Routing is enabled to protect respondent identity.Non-ProfitRun Privacy-Focused Surveys for validation & impact of your Non-Profit proposal, all at a special discounted price for Non-Profit Organizations.

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Learn the craft

Guides, templates and playbooks to help you run better research.

Use CasesThe Use Cases highlighting various applications of BlockSurvey for different business needs, including customer churn, employee exit, product market fit, and uninstall feedback surveys.AI GuidesThe AI Guides page provides resources on artificial intelligence, covering machine learning, natural language processing, and computer vision to help users innovate and stay updated.Survey GuidesThe BlockSurvey Guides page provides comprehensive resources on survey design, data security, and market research techniques for creating effective and secure surveys.PlaybooksStrategies and guides for capturing qualified leads using surveys across various niches.WebinarsGain Valuable Insights from top industry experts with our comprehensive webinar series.PodcastWatch our podcast episodes on survey design, data privacy, and research best practices.WhitepaperBeyond the Response Rate — qualitative research with 15 IR professionals at 15 U.S. institutions.

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Employee Counselling Form

An employee counselling form is a document used by employers to provide employees with guidance and support during difficult times at work. The form can be used to identify the employee's concerns, assess the situation and provide recommendations for resolving the issue.

3 minutes to complete

Eligibility

The Employee Counselling Form is available for all employees. If any employee is dealing with work-related concerns or problems they can fill out this form.

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Questions for Employee Counselling Form

Questions for Employee Counselling Form

1.

Employee Name

The answer should be a text input.

2.

Phone Number

The answer should be a phone number.

3.

Email ID

The answer should be an email input.

4.

Department

The answer should be a text input.

5.

Supervisor's Name

The answer should be a text input.

6.

Reasons for Counselling

The answer should be a single choice:

Work Stress
Financial Problems
Work Relationship
Physical Health
Traumatic Events

7.

Could you explain why you're seeking counselling in more detail?

The answer should be a text input.

8.

Do you have any medical condition ?

The answer should be a single choice:

Yes
No

9.

Any history of mental illness in your family?

The answer should be a single choice:

Yes
No

10.

Are you referring someone else as a counsellor?

The answer should be a single choice:

Yes
No

11.

Are you comfortable discussing personal issues with your supervisor?

The answer should be a single choice:

Yes
No

12.

Please sign below to confirm that the information you have provided is correct to the best of your knowledge.

The answer should be a signature.

FAQs on Employee Counselling Form

: There is no definitive answer to this question as it will depend on the individual needs of the employees concerned. However, it is generally advisable to offer counselling on a regular basis, perhaps once or twice a month, in order to ensure that employees are able to resolve any issues they may be facing.
: Employee counselling can cover a wide range of topics, from work-related stress and anxiety to personal issues such as relationship problems or bereavement. Counsellors will work with employees to identify the root cause of their problems and help them to find ways to cope with and resolve these issues.
: The confidential nature of employee counselling is one of its key benefits. Counsellors are bound by strict ethical guidelines which protect the confidentiality of their clients. This means that employees can feel safe discussing sensitive personal issues.

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What people say

Join 500+ happy customers worldwide who are already using our amazing product.

Beyond Surveys—A Truly Multi-Purpose Tool

This platform goes far beyond basic surveys. I’ve used it for lead generation, landing page enrichment, and even embedded videos. Everything’s easy to use, well documented, and super flexible—whether you're building forms, quizzes, or something more advanced.

Martin G.Créateur de la Méthode Rashōmon

UI/UX is great and fast API processing

I think BlockSurvey is good for short and long surveys. What I find the best is the fact that there are so many templates I can use and customize.

Ankit M.AI Analyst Team Lead

AI form builder for top security and data privacy

Uses end-to-end encryption technology that allows users to create survey forms where data is secure and private. UI looks very beautiful.

Lou F.Creative Visionary

Nothing Like It — BlockSurvey Is in a League of Its Own!

From end-to-end encryption-level security and AI-generated questions to powerful logic flows and white-label domains, BlockSurvey has it all. It’s secure, innovative, and packed with features like calculations, templates, and in-app analytics. I use it to create personalized assessments for leadership training—nothing else compares.

Kim B.Founder/ President - International Leadership Trainer

Survey and Forms for Privacy and Security

BlockSurvey puts privacy and security above anything else. The use of end-to-end encryption is not a gimmick as in many products; it's a core feature enabling privacy and security. The survey building tools are impeccable. I've used numerous SaaS survey tools, and nothing comes close.

Trevor L.Chief Information Security Officer (CISO)

Big fan of BlockSurvey and what Wilson and the team are doing. BlockSurvey was the end-to-end encrypted product I signed up for and I love the UI, privacy, responsiveness, and transparency behind the platform. Great job all 'round and awesome to see it keep evolving.

James Longley@jameslongley

Unmatched Security & Stunning Response Rates

Few tools combine data confidentiality and form aesthetics like this one. The conversational design improved my response rate by 43%, and the webhook integrations made syncing to our CRM effortless. I also love how responsive and community-driven the support team is.

Kris R.Group Automation Manager

Powerful custom surveys

Creating surveys with BlockSurvey has been a breeze. The drag-and-drop interface is intuitive, and we’re able to collect data anonymously and securely—without intermediaries. It’s interactive, friendly, and encourages high participation while protecting user privacy. The reports are solid, and we’ve used it confidently for internal and external feedback.

Liz D.IT Support Specialist

Private, Beautiful Surveys That Build Trust

For our NGO, data privacy is everything—and this platform nails it. It keeps personal info fully protected while letting us design beautiful, chat-like surveys that increase engagement. Team collaboration features sealed the deal.

Luis Noel D.Director Comercial

Want to create secure online forms and surveys?Join BlockSurvey.