Cultural Competence Assessment Questionnaire
Please complete this questionnaire to help us assess and enhance cultural competence within our organization or community.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Role/Position
*
How would you rate your overall awareness of cultural differences in your work or community environment?
*
1
2
3
4
5
Please indicate your level of agreement with the following statements:
*
Rows
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I recognize my own cultural biases.
1
2
3
4
5
I am comfortable interacting with people from different cultural backgrounds.
6
7
8
9
10
I actively seek to learn about other cultures.
11
12
13
14
15
I adapt my communication style when interacting with people from different cultures.
16
17
18
19
20
I respect cultural differences even when they conflict with my own values.
21
22
23
24
25
How often do you participate in activities or training related to cultural competence?
*
Please Select
Never
Rarely
Sometimes
Often
Very Often
Which of the following best describes your experience working with culturally diverse groups?
*
Limited experience
Some experience
Extensive experience
Other
What resources or support would help you improve your cultural competence? (Select all that apply)
Workshops or training sessions
Access to cultural events
Mentorship or peer support
Educational materials (books, articles, videos)
Other
Please describe a situation where cultural competence was important in your work or community.
Do you have any suggestions for promoting cultural competence within our organization or community?
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Should be Empty: