Racial Equity Evaluation Form
Please provide your honest feedback to help us assess and improve racial equity within our organization or program.
Full Name
First Name
Last Name
Your Role or Position
*
Department / Program Being Evaluated
*
How would you rate the following aspects of racial equity in your department or program?
*
Rows
Needs Improvement
Fair
Good
Excellent
Recruitment and Hiring Practices
1
2
3
4
Promotion and Advancement Opportunities
5
6
7
8
Inclusion in Decision-Making
9
10
11
12
Access to Resources
13
14
15
16
Training and Professional Development
17
18
19
20
To what extent do you agree with the following statements?
*
Rows
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Leadership demonstrates commitment to racial equity.
21
22
23
24
25
Policies and procedures support racial equity.
26
27
28
29
30
There is open dialogue about race and equity.
31
32
33
34
35
Diverse perspectives are valued and included.
36
37
38
39
40
Incidents of discrimination are addressed promptly.
41
42
43
44
45
How would you rate your department or program's overall commitment to racial equity?
*
1
2
3
4
5
Have you observed any barriers to racial equity in your department or program?
*
Yes
No
Not Sure
If yes, please describe the barriers you have observed.
What suggestions do you have for improving racial equity?
Would you like to be involved in future racial equity initiatives?
Yes
No
Maybe
Additional Comments
Submit Evaluation
Should be Empty: