I feel fear or uncertainty related to a current change in my work. *

1 = Not at all true • 2 = Slightly true • 3 = Neutral • 4 = Mostly true • 5 = Completely true

1

2

3

4

5

I feel sadness or grief about something that is ending or shifting.

1 = Not at all true • 2 = Slightly true • 3 = Neutral • 4 = Mostly true • 5 = Completely true

1

2

3

4

5

I feel excited or hopeful about what this change might bring.

1 = Not at all true • 2 = Slightly true • 3 = Neutral • 4 = Mostly true • 5 = Completely true

1

2

3

4

5

I feel alone in how I’m experiencing this change.

1 = Not at all true • 2 = Slightly true • 3 = Neutral • 4 = Mostly true • 5 = Completely true

1

2

3

4

5

I find it difficult to talk about my fears or desires related to this change.

1 = Not at all true • 2 = Slightly true • 3 = Neutral • 4 = Mostly true • 5 = Completely true

1

2

3

4

5

I would like to feel more clarity and peace about this transition.

1 = Not at all true • 2 = Slightly true • 3 = Neutral • 4 = Mostly true • 5 = Completely true

1

2

3

4

5

I feel confident expressing difficult emotions or concerns at work.

1 = Not at all true • 2 = Slightly true • 3 = Neutral • 4 = Mostly true • 5 = Completely true

1

2

3

4

5

I feel heard and understood by my team.

1 = Not at all true • 2 = Slightly true • 3 = Neutral • 4 = Mostly true • 5 = Completely true

1

2

3

4

5

I hesitate to speak up because I don’t want to cause conflict or “add more noise.”

1 = Not at all true • 2 = Slightly true • 3 = Neutral • 4 = Mostly true • 5 = Completely true

1

2

3

4

5

We have clear channels and moments to talk about important topics.

1 = Not at all true • 2 = Slightly true • 3 = Neutral • 4 = Mostly true • 5 = Completely true

1

2

3

4

5

The session helped me better understand my emotional response to change. *

1 = Not at all true • 2 = Slightly true • 3 = Neutral • 4 = Mostly true • 5 = Completely true

1

2

3

4

5

I feel more able to express my fears, desires, or needs after this session. *

1 = Not at all true • 2 = Slightly true • 3 = Neutral • 4 = Mostly true • 5 = Completely true

1

2

3

4

5

I am leaving with new ways to approach communication in my team. *

1 = Not at all true • 2 = Slightly true • 3 = Neutral • 4 = Mostly true • 5 = Completely true

1

2

3

4

5

On a scale from 0–10, how likely are you to recommend this session to a colleague/other company? *

0,1,2,3 = Very unlikely • 4,5,6 = Unlikely • 7,8 =Likely • 9,10 = Very likely

1

2

3

4

5

6

7

8

9

10

I am very satisfied with the Workshop facilitation and take aways. *

1 = Not at all true • 2 = Slightly true • 3 = Neutral • 4 = Mostly true • 5 = Completely true

1

2

3

4

5

I would like to participate in similar sessions in the future. *

1 = Not at all true • 2 = Slightly true • 3 = Neutral • 4 = Mostly true • 5 = Completely true

1

2

3

4

5