Name *

First Name

Last Name

1. The company's purpose and mission is memorable *

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

2. I feel I can influence the workplace with my ideas *

Never

Seldom

Sometimes

Often

Always

3. Staff and leadership reflect the diversity of the population *

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

4. Our company has an inclusive environment for people of all races, religions, sexual orientations, physical/mental challenges *

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

5. Our values are distinctive, memorable and I can personally connect with them *

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

6. Our values do not have unintended consequences on how employees work together *

Never

Seldom

Sometimes

Often

Always

7. Leaders behave in a way that's consistent with the company values *

Never

Seldom

Sometimes

Often

Always

8. Employees and customers are treated with respect *

Never

Seldom

Sometimes

Often

Always

9. Employees treat each other and teams in other departments with respect *

Never

Seldom

Sometimes

Often

Always

10. Our culture is one of openness and trust, welcoming feedback at all levels *

Never

Seldom

Sometimes

Often

Always

11. We regularly make and honor our commitments to each other *

Never

Seldom

Sometimes

Often

Always

12. We have an entrepreneurial culture *

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

13. We execute our plans with purpose and urgency *

Never

Seldom

Sometimes

Often

Always

1. Management is flexible and adaptable to changes proposed *

Never

Seldom

Sometimes

Often

Always

2. Change happens quickly in this organization and isn’t disruptive *

Never

Seldom

Sometimes

Often

Always

3. Employees are empowered to adjust to changes *

Never

Seldom

Sometimes

Often

Always

4. Our company has structures and framework that guide activities and provide stability *

Never

Seldom

Sometimes

Often

Always

5. We have an agile culture by observing, analyzing and adjusting *

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

6. We encourage staff to discover problems, correct them and communicate the results *

Never

Seldom

Sometimes

Often

Always

7. We analyze ability to accept change when assessing individual and organizational capacity. *

Never

Seldom

Sometimes

Often

Always

1. Individuals and teams have clearly defined goals that relate to the mission and vision of the organization *

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

2. Individuals, teams, and functional areas have compatible goals *

Never

Seldom

Sometimes

Often

Always

3. Managers at all levels work in tandem to achieve the goals *

Never

Seldom

Sometimes

Often

Always

4. Management doesn’t compromise company policies and principles to achieve its goals *

Never

Seldom

Sometimes

Often

Always

1. Management is concerned about the issues faced by the employees in the organization *

Never

Seldom

Sometimes

Often

Always

2. Teams have the authority needed to get the tasks done *

Never

Seldom

Sometimes

Often

Always

3. Management provides enough support and focus to meet the needs of clients and customers *

Never

Seldom

Sometimes

Often

Always

4. People value each other in a Team *

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

5. Management accepts responsibility if things don’t work out well in this organization *

Never

Seldom

Sometimes

Often

Always

6. Managers and supervisors treat employees with respect *

Never

Seldom

Sometimes

Often

Always

7. My contribution is valued by management and team members *

Never

Seldom

Sometimes

Often

Always

1. The policies and procedures help me get my job done *

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

2. I have a clear understanding of how to proceed throughout the process of change *

Never

Seldom

Sometimes

Often

Always

1. Our company is a leader in its industry *

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

2. We have programs that promote employee innovation *

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

3. Employees work well together and are they given the tools to collaborate and innovate *

Never

Seldom

Sometimes

Often

Always

1. Our employees are compensated well compared to the industry *

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

2. There is an employee development program *

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

3. When performance is lacking, it is dealt with immediately *

Never

Seldom

Sometimes

Often

Always