Remote Worker Pre-test Assessment Form
Assess remote work readiness, setup, communication preferences, and support needs before work begins. Use the exact title consistently across the form.
Remote Readiness Basics
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Job Title / Role
*
Primary Time Zone
*
Please Select
UTC−12:00
UTC−11:00
UTC−10:00
UTC−9:00
UTC−8:00
UTC−7:00
UTC−6:00
UTC−5:00
UTC−4:00
UTC−3:00
UTC−2:00
UTC−1:00
UTC±0:00
UTC+1:00
UTC+2:00
UTC+3:00
UTC+4:00
UTC+5:00
UTC+5:30
UTC+6:00
UTC+7:00
UTC+8:00
UTC+9:00
UTC+10:00
UTC+11:00
UTC+12:00
UTC+13:00
Other
Remote Work Environment Assessment
Home work location type
Dedicated home office
Shared space
Co-working space
Other
Internet reliability rating
*
1
2
3
4
5
Device availability
Laptop
External monitor
Headset
Webcam
Stable internet
Other essentials
Self-assessed remote work readiness score
*
Not ready
1
2
3
4
5
6
7
8
9
Fully ready
10
1 is Not ready, 10 is Fully ready
Workflow, Communication, and Constraints
Primary communication method
Email
Chat
Video calls
Phone
Other
Preferred meeting availability
*
Hour Minutes
AM
PM
AM/PM Option
Blockers or support needed before starting remote work
*
Submit Assessment
Should be Empty: