Cultural Diversity Self-assessment Form
Assess your cultural diversity awareness, inclusive behaviors, and areas for growth.
Assessment Profile
Department / Role / Team
*
Organizational Level / Work Setting
*
Individual Contributor
Team Lead
Manager
Senior Leader
HR / People Team
Remote Worker
Hybrid Worker
On-site Worker
Other
Time with Organization / Team
*
Please Select
Less than 6 months
6–12 months
1–2 years
3–5 years
More than 5 years
Cultural Awareness and Inclusion Assessment
Cultural awareness and inclusion assessment
*
Rows
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I feel comfortable working with people from different cultural backgrounds.
1
2
3
4
5
I am aware that cultural norms can influence workplace behavior and expectations.
6
7
8
9
10
I respect and adapt to different communication styles in collaborative settings.
11
12
13
14
15
I make an effort to include all team members in everyday collaboration and decision-making.
16
17
18
19
20
Frequency of inclusive behaviors
*
Rows
Never
Rarely
Sometimes
Often
Always
I ask respectful questions when I do not understand a cultural practice.
21
22
23
24
25
I adapt my communication to ensure others feel heard and understood.
26
27
28
29
30
I actively seek perspectives from colleagues with different backgrounds.
31
32
33
34
35
I include others in conversations and activities rather than leaving them out.
36
37
38
39
40
Cross-cultural collaboration confidence
Rows
Not at all confident
Slightly confident
Moderately confident
Very confident
Extremely confident
Understanding how cultural differences may affect teamwork.
41
42
43
44
45
Navigating misunderstandings related to culture or communication style.
46
47
48
49
50
Creating an inclusive environment in group discussions.
51
52
53
54
55
Recognizing and respecting cultural differences in everyday work.
56
57
58
59
60
Overall self-rating on cultural inclusion
*
Needs significant improvement
1
2
3
4
5
6
7
8
9
Excellent inclusive practice
10
1 is Needs significant improvement, 10 is Excellent inclusive practice
Self-Reflection and Development
What are your strengths in cultural diversity and inclusive behavior?
What specific actions will you take to improve your cultural awareness and inclusion practices?
Overall Self-Assessment Summary
Overall cultural diversity competence/confidence
*
1
2
3
4
5
Additional comments or context
Submit
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