Communication Values Survey Form
Please complete the Communication Values Survey Form to help us better understand attitudes and behaviors related to effective communication.
How important are the following aspects of communication to you?
*
Rows
Not Important
Slightly Important
Moderately Important
Very Important
Extremely Important
Active listening
1
2
3
4
5
Clarity of message
6
7
8
9
10
Empathy in conversation
11
12
13
14
15
Openness to feedback
16
17
18
19
20
I feel comfortable expressing my opinions in group discussions.
*
Strongly Disagree
1
2
3
4
Strongly Agree
5
1 is Strongly Disagree, 5 is Strongly Agree
How often do you seek feedback on your communication style?
*
Never
Rarely
Sometimes
Often
Always
Rate your satisfaction with your current communication skills.
*
1
2
3
4
5
When communicating with others, how frequently do you adapt your style based on the audience?
*
Never
Rarely
Sometimes
Often
Always
To what extent do you agree with the following statements?
*
Rows
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I value honesty in communication.
21
22
23
24
25
I am open to constructive criticism.
26
27
28
29
30
I avoid interrupting others.
31
32
33
34
35
I try to understand different perspectives.
36
37
38
39
40
What is your preferred method of communication?
*
In-person
Phone call
Video call
Email
Messaging app
Other
How comfortable are you giving feedback to others?
*
Not Comfortable
1
2
3
4
Very Comfortable
5
1 is Not Comfortable, 5 is Very Comfortable
Please describe a situation where effective communication made a positive difference for you.
What is one area of communication you would like to improve?
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