Self Survey Sheet

Instructions: Use the scale below to indicate how each statement applies to your team. Be sure to evaluate the statements honestly and without over thinking your answers. 3 = Usually, 2 = Sometimes, 1 = Rarely
Name (optional): 


A red asterisk (*) indicates required questions.

  1. I feel passionate and unguarded about discussion of issues.
    1 = Rarely, 2 = Sometimes, 3 = Usually*
     
      1 2 3  
    Rarely  Usually


  1. I feel comfortable expressing my deficiencies or unproductive behaviors as well as my teams.
    1 = Rarely, 2 = Sometimes, 3 = Usually*
     
      1 2 3  
    Rarely  Usually


  1. Team members know what their peers are working on and how they contribute to the collective good of the team.
    1 = Rarely, 2 = Sometimes, 3 = Usually*
     
      1 2 3  
    Rarely  Usually


  1. I feel comfortable quickly and genuinely apologizing to my team or Supervisor when something is said that is inappropriate or possibly damaging to the team.
    1 = Rarely, 2 = Sometimes, 3 = Usually
    *
     
      1 2 3  
    Rarely  Usually


  1. I willingly make sacrifices for the good of the team.
    1 = Rarely, 2 = Sometimes, 3 = Usually*
     
      1 2 3  
    Rarely  Usually


  1. I feel comfortable openly admitting my opportunities for improvement and mistakes.
    1 = Rarely, 2 = Sometimes, 3 = Usually*
     
      1 2 3  
    Rarely  Usually


  1. Team meetings are compelling and interesting, not boring.
    1 = Rarely, 2 = Sometimes, 3 = Usually*
     
      1 2 3  
    Rarely  Usually


  1. Team members leave meetings confident that their peers are completely committed to the decisions agreed upon during the meeting, even if there was initial disagreement.
    1 = Rarely, 2 = Sometimes, 3 = Usually*
     
      1 2 3  
    Rarely  Usually


  1. Morale is significantly affected by the failure to achieve team goals.
    1 = Rarely, 2 = Sometimes, 3 = Usually*
     
      1 2 3  
    Rarely  Usually


  1. During team meetings, the most important and most difficult issues are put on the table to be resolved.
    1 = Rarely, 2 = Sometimes, 3 = Usually*
     
      1 2 3  
    Rarely  Usually


  1. Team members are deeply concerned about the prospect of letting down their peers and department.
    1 = Rarely, 2 = Sometimes, 3 = Usually*
     
      1 2 3  
    Rarely  Usually


  1. Our team works closely together, so that we don’t feel like we work with complete strangers.
    1 = Rarely, 2 = Sometimes, 3 = Usually*
     
      1 2 3  
    Rarely  Usually


  1. Team members end discussions with clear and specific resolutions and calls to action.
    1 = Rarely, 2 = Sometimes, 3 = Usually*
     
      1 2 3  
    Rarely  Usually


  1. Team members positively challenge one another about their approaches to customer service.
    1 = Rarely, 2 = Sometimes, 3 = Usually*
     
      1 2 3  
    Rarely  Usually


  1. Team members are slow to seek credit for their own contributions but quick to point out those of others.
    1 = Rarely, 2 = Sometimes, 3 = Usually*
     
      1 2 3  
    Rarely  Usually


  1. My coaching sessions are effective and provide specifics on how I can improve.
    1 = Rarely, 2 = Sometimes, 3 = Usually*
     
      1 2 3  
    Rarely  Usually





Training
Vonage University
Holmdel, NJ