Workplace Productivity AssessmentTM

For the questions below, please answer using the following scale:
This statement...
5 ...describes me/my situation perfectly
4 ...describes me/my situation fairly often
3 ...describes a situation that does not apply to me in my workplace
2 ...describes me/my situation occasionally
1 ...does not describe me/my situation at all
1) I know where to file my papers.
  1 2 3 4 5
2) I am able to quickly and easily retrieve papers I have filed.
  1 2 3 4 5
3) I have a clear plan for each day.
  1 2 3 4 5
4) My office space is adequate for my needs.
  1 2 3 4 5
5) I have the appropriate office furniture for my needs.
  1 2 3 4 5
6) I consistently do the most important tasks first.
  1 2 3 4 5
7) If I were to be out of the office unexpectedly I have a plan for how my responsibiliies should be handled in my absence.
  1 2 3 4 5
8) I have a clear understanding of my job responsibilities.
  1 2 3 4 5
9) My workload is generally reasonable and I feel I should be able to accomplish what I need to.
  1 2 3 4 5
10) I usually accomplish the projects/tasks I set out to do.
  1 2 3 4 5
11) I am able to focus when necessary.
  1 2 3 4 5
12) I have a good process for handling current tasks and projects.
  1 2 3 4 5
13) I have a good process for handling incoming mail.
  1 2 3 4 5
14) I have a good process for handling incoming email.
  1 2 3 4 5
15) I know where to store electronic information on my computer.
  1 2 3 4 5
16) I am able to quickly and easily retrieve electronic information from my computer.
  1 2 3 4 5
17) With regard to my professional and personal life, I am satisfied with how my time is spent.
  1 2 3 4 5
 
Why do you seek change in your workplace environment?
 
What are your expectations regarding how quickly change could be implemented?
 
How motivated and/or committed are you to making some changes? Please explain.
Name:   Phone:   Email:
Best day/time/method to reach you:

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