Can this assessment be signed electronically?

Yes. Electronic signatures are generally legally enforceable under the federal ESIGN Act (15 U.S.C. ch. 96) and state UETA laws where adopted; the form must meet intent, consent, attribution, and retention requirements.

Is notarization required for validity?

Not typically. Notarization is unnecessary for standard preference assessments unless the form is combined with a document that statutorily requires notarization or witness attestation.

How long should we keep completed assessments?

Retain active employment records for the employment term plus a minimum of three years; healthcare-related records follow HIPAA retention rules (45 CFR §164.530(j)).

What authentication level is recommended?

Use email plus SMS code or SSO for employee authentication. Increase strength (KBA or multi-factor) for sensitive or high-risk data.

How do we correct an employee's submitted preference?

Collect a signed amendment or a new assessment dated and signed by the employee; preserve the prior record for auditability and change tracking.

Who should review assessments for accommodation requests?

HR and the employee's manager should review requests in concert with legal or occupational health when necessary to determine reasonable accommodations and document the decision.

Electronic Signature
Templates
HR
Employee Preference Assessment

Employee Preference Assessment

This template is fully customizable. Edit the text, fill out the fields, and send it for signature. Give it a try!

EMPLOYEE PREFERENCE ASSESSMENT

Purpose: This Employee Preference Assessment documents an employee's work, schedule, development and workplace accommodation preferences to assist in assignment, scheduling, and professional development planning. Completion of this form does not alter or create any contractual terms of employment unless expressly agreed in writing by authorized company representatives.

Personal Information

Full Legal Name Current Address

Phone:

Email:

Employee ID:

Position Information

Current Job Title Department

Reporting Manager:

Current Supervisor:

Current or Preferred Start Date for New Assignment

Work Location & Schedule Preferences

Preferred Work Arrangement: Remote Hybrid On-site

Employment Type Preference: Full-time Part-time Temporary/Contract

Preferred Days and Hours Willingness to Work Flexible Shifts or Overtime

Yes No If Yes, describe limits or preferences:

Work Style & Team Preferences

Preferred Team Size Preferred Role Type Primary Work Preferences (rank or explain)

Technology, Equipment & Accessibility

Company Equipment Required Accommodation Requests

Career Development & Interests

Areas of Interest for Training or Advancement Desired Timeframe for Development or Promotion

Employment History (Most Recent)

Employer 1 — Company Name

Title:

Dates Employed:

Primary Responsibilities Reason for Leaving Employer 2 — Company Name

Title:

Dates Employed:

Primary Responsibilities Reason for Leaving

Education

Highest Degree or Certification Institution Graduation or Completion Date

References (Professional)

Reference 1

Phone:

Email:

Relationship:

Reference 2

Phone:

Email:

Relationship:

Reference 3

Phone:

Email:

Relationship:

Legal Acknowledgements & Authorizations

At-Will Employment Acknowledgement:

I acknowledge that, unless I have a written agreement signed by an authorized representative of the employer specifying otherwise, my employment is at-will, which means either I or the employer may terminate the employment relationship at any time, with or without cause and with or without notice.

Acknowledge At-Will

I acknowledge the At-Will Employment statement above.

Equal Employment Opportunity:

The employer is an equal opportunity employer. Employment decisions are based on business needs, job requirements and individual qualifications, without regard to protected characteristics under applicable law.

Acknowledge EEO

I acknowledge the Equal Employment Opportunity statement above.

Authorization to Verify and Release Information:

I authorize the employer and its agents to verify the information I have provided, to contact references and former employers, and to obtain consumer and criminal background checks, where permitted by law, for employment, placement, or development purposes. I release from liability all persons and organizations providing information in good faith.

Consent to Verify

I consent to verification of my employment history, references, educational credentials, and background checks as described above.

Applicant Certification

I certify that the information provided on this Employee Preference Assessment is true, complete and accurate to the best of my knowledge. I understand that false statements, omissions, or misrepresentations may result in discipline up to and including termination of employment or withdrawal of an offer. I agree to promptly notify the employer of any changes to the information provided.

I understand that this form will be used for workforce planning and that completion does not guarantee assignment to any specific schedule, location, or position. I authorize the use of this information for internal placement and development decisions.

Optional Comments

Printed Name:

Signature:

Date:

What an Employee Preference Assessment Is

An Employee Preference Assessment is a standardized form used by employers to collect workers' preferences about schedules, work location (on-site, hybrid, remote), shift times, role responsibilities, and training or career-development interests. Organizations use the collected data to inform staffing, shift assignments, accommodations, and workforce-planning models while keeping an auditable record of employee requests. The document can be implemented as a one-time intake, recurring survey, or part of onboarding materials and is commonly stored with personnel records for operational and compliance purposes.

Why employers use this assessment

Collecting employee preferences centralizes scheduling inputs, reduces back-and-forth coordination, and supports data-driven staffing decisions. It helps align workforce availability with operational needs, supports accommodation requests, and documents expressed preferences for later personnel decisions.

Who completes and reviews these assessments

Employers, HR teams, managers, and employees each play specific roles in using Employee Preference Assessments.

HR managers and workforce planners who consolidate preferences and produce staffing plans.
Line managers and schedulers who apply preferences when creating rosters and assignments.
Employees and new hires who complete and update their preference selections and consent options.

Clear role separation—who collects, who reviews, who stores—reduces errors and protects employee privacy.

Core sections to include in a professional assessment

A complete Employee Preference Assessment organizes demographic identifiers, availability windows, work-mode preferences, priority settings, consent and privacy options, and reporting fields so responses are actionable and auditable.

Employee Details

Full legal name, employee ID, department, job title, and contact details so responses map to personnel records and payroll systems.

Preference Categories

Options for work mode, preferred shifts, overtime willingness, commute considerations, and desired training to capture structured preference data.

Availability Grid

Day/time grid or calendar inputs for actual availability and blackout dates to avoid scheduling conflicts and respect leave requests.

Priority Weighting

Fields allowing employees to rank or weight multiple preferences so algorithms or managers can balance competing needs.

Consent & Privacy

Clear consent checkboxes describing how preference data will be used, stored, and shared internally to meet privacy expectations.

Reporting Fields

Administrative fields for HR use: collection date, reviewer name, status, and audit entries to maintain an evidence trail.

Quick steps to fill out the assessment

Follow these steps in order to submit a complete, auditable Employee Preference Assessment.

01

Open the form: Access the current template from HR or the provided secure link.
02

Enter identifiers: Complete name, employee ID, department, and contact fields.
03

Record preferences: Select work mode and enter availability on the grid.
04

Review and sign: Confirm accuracy, sign, and submit to HR.

How assessment data moves through your HR workflow

A standard workflow routes completed assessments from the employee to HR and then to schedulers or managers who take action based on documented preferences.

Employee Submission: Employee completes and signs the form online or on paper.
HR Intake: HR validates identifiers and logs the response into personnel records.
Manager Review: Managers receive summarized preferences for scheduling decisions.
Update Records: Final assignments and any accommodations are recorded and retained.

Typical digital workflow settings

Configure routing, authentication, and archive settings before mass distribution to ensure consistent handling and auditability.

Field	Configuration
Routing Order	Sequential by role
Signer Authentication	Email or SMS code
Auto-Reminders	Enabled, 3 reminders
Archive Location	HR secure records

Digital distribution and signing requirements

Use secure channels and supported file formats when sending the assessment to employees.

File Formats: PDF, DOCX supported
Integrations: Salesforce, Microsoft 365, NetSuite
Authentication: Email, SMS, SSO

Key data and security considerations

Encryption: TLS 1.2/1.3 in transit; AES-256 at rest

Access Controls: Role-based access and audit logging

HIPAA Considerations: BAA required for PHI handling

Audit Trail: Timestamps, IP, and action history

Retention Flags: Automated retention and legal holds

Authentication: Multi-factor and SSO options

Risks of improper collection or use

Discrimination Risk: Uneven use can trigger discrimination claims

Privacy Breach: Unauthorized access risks HIPAA/CCPA issues

Record Mismatch: Incorrect identifiers lead to payroll errors

Non-Compliance: Missing consent for consumer-facing data

Scheduling Errors: Ignored preferences cause operational disruption

Audit Exposure: Lack of audit trail undermines defensibility

Common mistakes to avoid

Collecting free-text availability instead of structured time blocks, which complicates automated scheduling and causes parsing errors.
Failing to obtain explicit consent for how preference data will be used, shared, or stored, increasing legal and privacy risk.
Not validating employee identifiers against HRIS leading to mismatched records and incorrect assignment or payroll routing.
Ignoring accommodation or ADA requests documented in the assessment, which can lead to compliance and liability issues.

eSignature vendor pricing and capability snapshot

High-level pricing and capability comparison for common eSignature providers; signNow is listed first per table conventions.

	signNow	DocuSign	Adobe Sign	PandaDoc	HelloSign
Starting Price	$8/user/mo	$15/user/mo	$14/user/mo	$19/user/mo	$15/user/mo
Free Trial	Yes — 7-day free trial	Yes — trial available	Yes — trial available	Yes — trial available	Yes — trial available
Bulk Send	Yes	Yes	Yes	Yes	No
Audit Trail	Yes	Yes	Yes	Yes	Yes
HIPAA Compliant	Yes	Yes	Yes	No	No
Envelope Cap	No cap	100 envelopes/user/year	Varies by plan	Varies by plan	Varies by plan

Frequently asked questions

Answers to common questions about using and signing an Employee Preference Assessment, including legal validity, storage, and signing options.

Need help? Contact support

Can this assessment be signed electronically?
Yes. Electronic signatures are generally legally enforceable under the federal ESIGN Act (15 U.S.C. ch. 96) and state UETA laws where adopted; the form must meet intent, consent, attribution, and retention requirements.
Is notarization required for validity?
Not typically. Notarization is unnecessary for standard preference assessments unless the form is combined with a document that statutorily requires notarization or witness attestation.
How long should we keep completed assessments?
Retain active employment records for the employment term plus a minimum of three years; healthcare-related records follow HIPAA retention rules (45 CFR §164.530(j)).
What authentication level is recommended?
Use email plus SMS code or SSO for employee authentication. Increase strength (KBA or multi-factor) for sensitive or high-risk data.
How do we correct an employee's submitted preference?
Collect a signed amendment or a new assessment dated and signed by the employee; preserve the prior record for auditability and change tracking.
Who should review assessments for accommodation requests?
HR and the employee's manager should review requests in concert with legal or occupational health when necessary to determine reasonable accommodations and document the decision.

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