Name *

First Name

Last Name

Phone number: *

(###)

###

####

1. Do you have an employee privacy policy that discusses security of employee data? *

Yes

No

2. Describe your company's ownership structure: *

Public company

Private company

3. Is your company a non-profit? *

Yes

No

4. How many employees do you have? All employees on payroll must be included. *

Less than 5

5 or more

10 - 50

50 - 99

100 to 999

999+

5. Which best describes your annual revenue? *

Less than $2.25 million

$2.25 - $3 million

$3 million - $25 million

$25 million or more

6. In which of the following countries do you have employees? *

Select all that apply.

US

Canada

Australia

European Union (Austria, Belgium, Bulgaria, Croatia, Republic of Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden)

United Kingdom (England, Scotland, Wales, Northern Ireland)

India

Switzerland

Norway

Other

7. In which US states do you have employees? *

All 50 states

Not all 50 states

8. Do you have employees in the following safety and security-sensitive fields: *

Security (bodyguards, bouncers, armored car drivers, etc.)

Pharmaceutical industry

Healthcare

Banking/financial

Federal contract work

Hospitality (incl. restaurants and retailers )

Childcare

Government/public employees

Public utilities

National protection of life and property

Other public health or safety field (aviation, traffic control, etc.)

None

Other

9. Are you a school or educational institution that receives funds under a program of the US Department of Education? *

Yes

No

10. Do you conduct background checks? *

Yes

No

More information

11. Do you collect information about prescription drug use as part of the pre-hiring or pre-promotion drug testing process? *

Yes

No

12. Do you use automated decision-making tools or other AI tools to assist with hiring or other employment decisions? *

Yes

No

1. Which of the following pre-employment information do you collect from job applicants? *

Resumes

Employment applications

References

Consumer reports

Credit checks

Personality testing

Social media profile information

2. Which of the following sensitive information do you collect from job applicants? *

Race

National origin

Sex

Religion or philosophical beliefs

Union membership

Citizenship and immigration status

Disability

Genetic information

Age

Sexual orientation

Criminal history

None

3. Which of the following biometric information do you collect from job applicants? *

Drug test results

Prescription drug information

Vaccination records

Medical records

Fingerprint

Facial scan

Voice

Iris scan

Other biometric information

None

4. Do you use polygraph/lie detector testing as part of the hiring process? *

Yes

No

1. Which of the following new hire/onboarding information do you collect from employees? *

Social security numbers

Drivers' license numbers

Mailing addresses

Email addresses

IRS forms

Immigration forms

2. Which of the following types of administrative data do you collect from employees? *

Employee evaluations

Professional certifications

Memberships in professional organizations

Other

3. Do you collect employee bank and/or credit card numbers or other financial account information? (i.e. for payroll or expense reports) *

Yes

No

4. Which of the following biometric information do you collect from employees? *

Drug test results

Prescription drug information

Vaccination records

Medical records

Fingerprint

Facial scan

Voice

Iris scan

None

Other biometric information (including infectious disease info)

5. Which of the following sensitive information do you collect from employees? *

Race

National origin

Sex

Religion or philosophical beliefs

Union membership

Citizenship and immigration status

Disability

Genetic information

Age

Sexual orientation

Criminal history

None

6. Do you collect documentation for sick leave, vacation, paid time off, FMLA leave, paternity leave? *

Yes

No

7. In what ways do you monitor employee activity? *

Video cameras

Facial/other biometric scans

Activity on a work computer or system, such as browsing history, search history, and interactions with the employer's and other websites and applications

Activity on personal devices when connected to work WiFi

Chat information

Other

8. Please list any other employee data you collect: *

Non-exempt employee benefit plan data

Geolocation

Device information

Criminal or public records (such as bankruptcy filings or worker's compensation appeals)

Non-public criminal records

Other

1. Do you provide employees with devices such as laptops or phones? Please explain as necessary. *

Yes

No

2. Do work-owned employee devices employ biometric security mechanisms, such as a facial scan lock or fingerprint lock? *

Yes

No

3. Please indicate which technical and organizational security measures you implement for customer and/or employee data, and please explain as needed: *

Data encryption

Multi-factor authentication

Pseudonymization

VPNs

Network security monitoring (to identify unauthorized activity)

Data retention policies

4. Where are employee records held or stored? *

In America, on a computer

In America, paper copies

Other