Sample Team Survey

- Instructions -

  • This survey must be completed by a person expressing their own attitudes regarding their experience as a Team member.

  • A response must be given to the Identifying Information section, each of the 10 Team Assessment sample questions and the Demographic Information that follows the questions.

  • At the end of the form be sure to click the 'submit' button.




 Identifying Information

For purposes of verifying your identity and collating your responses

please provide the following information about yourself:

First Name:
Last Name:
What is your Company?
What is your Employee e-mail address: 
Please enter your Employee ID (including leading zeros if any).  This ID will be used to identify you in order to provide feedback reports and analysis:

 

   

Very Strongly
Disagree

Strongly
Disagree

Disagree

Agree

Strongly
Agree

Very Strongly
Agree

1.
Team members are enthusiastic about being part of this team.

2.
Team members ask questions that help clarify the task.

3.
Team members provide each other with information.

4.
The goal of the team is more important than any one member.

5.
Team members are committed to the goals of the group.

6.
The team has sufficient skills needed to saccomplish it's goals.

7.
Team members are extremely proud of this unit.

8.
Team members accommodate to each other's needs.

9.
Team members make ethical decisions.

10.
The team develops new structures and roles as needed.



Please enter any comments which you feel are relevant to your experience as part of the Team!



Demographic Information

 

What is your Age?


What is your Sex?   Male:   Female:


 
Caucasian
Bi-racial
Hispanic, Latino/a
African-American
Asian or
Pacific Islander
American Indian or Native Alaskan
Multi-racial
Other
 specify below
Which of the following categories best describes your race or ethnicity?


Other Race:







FORM SUBMISSION

Thank you for taking the time to answer the questions in the self-assessment.

By clicking the SUBMIT FORM button your responses will be submitted for analysis.

 

To erase this form and start over.   Press the Clear Form button.  

Please Note: This will Delete Everything you have entered on this page.

Thank you for completing this assessment!!!

 

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