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0%
 
 
* Name:
   
 
 

Department:
 
 

Manager:
 
 

* I spend _______ of my day writing and responding to emails
 
Less than 10%
 
10% - 25%
 
25% - 40%
 
40% - 55%
 
More than 55%
 
 

* I spend ______ of my day talking to customers/suppliers on the phone.
 
None
 
Less than 5%
 
5% - 20%
 
20% - 35%
 
35% - 50%
 
More than 50%
 
 

* On average, I am in meetings for ______ of my week.
 
Less than 10%
 
10% - 25%
 
25% - 40%
 
40% - 55%
 
More than 55%
 
 

* _____ of the work that I do is administrative.
 
None
 
Less than 5%
 
5% - 20%
 
20% - 35%
 
35% - 50%
 
More than 50%
 
 

* I am currently working on ________ projects.
 
0
 
1 - 2
 
3 - 4
 
4 -5
 
5+
 
 
 
Please indicate the titles of the project(s) you are working on.
   
 
 
 
Additional Comments/Suggestions for improvement
   
 
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