Change Readiness Survey
Employee Feedback Worksheet
Rank the following statements
1=strongly disagree, 5=strongly agree, NA=not applicable
Awareness
I understand the business reasons for the change.
1 2 3 4 5 NA
I understand the risks of not changing.
1 2 3 4 5 NA
I understand the impact on my day-to-day work activities.
1 2 3 4 5 NA
Desire
I am personally motivated to be part of the change.
1 2 3 4 5 NA
I look forward to the new, changed environment.
1 2 3 4 5 NA
My peers support the change.
1 2 3 4 5 NA
My supervisors and managers support the change.
1 2 3 4 5 NA
Executives and key business leaders support the change.
1 2 3 4 5 NA
CRICOS Provider 00025B • TEQSA PRV12080 1
Knowledge
I have the skills and knowledge to be successful during the change.
1 2 3 4 5 NA
I have the skills and knowledge to be successful after the change.
1 2 3 4 5 NA
Training has been adequate to prepare me.
1 2 3 4 5 NA
Ability
I have the ability to perform the new duties required by the change.
1 2 3 4 5 NA
I can get support when I have problems and questions.
1 2 3 4 5 NA
I have practice at performing in the new environment.
1 2 3 4 5 NA
Reinforcement
The organisation is committed to keeping the change in place.
1 2 3 4 5 NA
I know the consequences of not performing my new activities.
1 2 3 4 5 NA
I am rewarded for performing in the new way.
1 2 3 4 5 NA
Comments and improvement suggestions:
CRICOS Provider 00025B • TEQSA PRV12080 2