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Questions marked with a * are required Exit Survey
 
 
* Rate your awareness of the business need to change on a scale of 1 (I am not aware) to 5 (I am fully aware).
 
1
 
2
 
3
 
4
 
5
 
 
 
* Rate your overall desire to change on a scale of 1 (I have little desire) to 5 (I have a strong desire).
 
1
 
2
 
3
 
4
 
5
 
 
 
* Assess which group you are in when it comes to desire to make the change.
 
Group 1: Motivated to change simply by understanding what is happening. You are a willing participant and active supporter.
 
Group 2: Neutral or cautious. You will need to understand how it impacts you personally and the risk if a change is not made.
 
Group 3: Unsupportive. You will not support the change no matter what is done. You will either obstruct or be a passive observer.
 
 
 
* Rate your knowledge of how to implement the change on a scale of 1 (I do not have the training or required knowledge) to 5 (I have training and the required knowledge)
 
1
 
2
 
3
 
4
 
5
 
 
 
* Rate your overall ability to support the change on a scale of 1 (I have not yet developed the skills and behaviors) to 5 (I have mastered the skills and behaviors).
 
1
 
2
 
3
 
4
 
5
 
 
 
* Rate the degree to which you are receiving reinforcement for demonstrating the change on a scale of 1 (I am not receiving reinforcement) to 5 (I am receiving reinforcement).
 
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5
 
 
 
* Choose the first area where you scored a 3 or below.
 
Awareness
 
Desire
 
Knowledge
 
Ability
 
Reinforcement