Nonprofit Staff Wellness Check-In Form — Form Fields
This nonprofit template includes 9 fields. A monthly wellness check-in for nonprofit staff to flag burnout risks and support needs. Free to customize and use on ZenBuild.
Staff Name (text, required)
Department/Program (text, required)
Month/Year (text, required)
How are you feeling about your workload this month? (rating, required)
How supported do you feel by leadership? (rating, required)
Are you experiencing signs of burnout? (dropdown selection, required) — options: Not at all, Occasionally, Frequently, Yes, I need support
What resources or support would help you most right now? (long text, optional)
Would you like to speak privately with someone from HR or leadership? (checkboxes, optional)
