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Culture Assessment Form
Please answer the following questions openly and honestly.
From a scale of broken (1) to highly functioning (10), what is the level of health of your team?
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From a scale of constant conflict (1) to no conflict (1), what is the level of conflict on the team?
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From a scale of no freedom (1) to complete freedom (10), how much freedom do you feel you have to express your opinions?
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On a scale of bare minimum (1) to full potential (10), what level are you contributing of your fullest potential?
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On a scale of lack of trust (1) to complete trust (10), how would you rate the level of trust on your team?
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On a scale of withholding (1) to open & transparent, how effective is the team at communication
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On a scale of demand for results (1) to care for people (10), does your work culture represent more high demand for results or high care for the people?
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Please choose the top area of development that would have the biggest impact on your team?
Giving and receiving feedback
Deepening trust
Accountability – holding myself and others to account
Being able to work well without guidance
Challenging conversations
Clearing log jams in relationships
Powerful planning
Time management
Celebrating successes
Acknowledgment
Leveraging each other’s skills
Commitment to Results
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