PERSONAL EFFECTIVENESS QUOTIENT

Name: Date:

HABIT 1: BE PROACTIVE

0 - 100
1) I work to solve problems rather than avoiding them. Strongly Strongly
Disagree Agree

100 - 0
2) I find it hard to maintain self-control, especially in difficult or Strongly Strongly
emotional circumstances. Disagree Agree

0 - 100
3) I accept responsibility for my actions rather than making excuses. Strongly Strongly
Disagree Agree

100 - 0
4) I often feel anxious about things I have no control over. Strongly Strongly
Disagree Agree

0 - 100
5) I don't let outside circumstances or other people dictate my attitude Strongly Strongly
or behavior. Disagree Agree

100 - 0
6) I feel like my life is out of my control and I have little say in how Strongly Strongly
things will work out. Disagree Agree

0 - 100
7) I typically stay calm during events that feel overwhelming. Strongly Strongly
Disagree Agree

100 - 0
8) I find it hard not to blame others when things go wrong. Strongly Strongly
Disagree Agree
 PERSONAL EFFECTIVENESS QUOTIENT

Name: Date:

HABIT 2: BEGIN WITH THE END IN MIND

0 - 100
9) I am organized when conducting meetings. Strongly Strongly
Disagree Agree

0 - 100
10) I rarely begin projects with a clear understanding of desired Strongly Strongly
outcomes. Disagree Agree

0 - 100
11) I set clear expectations with individuals when assigning tasks. Strongly Strongly
Disagree Agree

0 - 100
12) I wish I had a greater sense of direction in life. Strongly Strongly
Disagree Agree

0 - 100
13) I don't know what contribution I want to make in my current work Strongly Strongly
role. Disagree Agree

0 - 100
14) I have long-term goals in life. Strongly Strongly
Disagree Agree

0 - 100
15) I decide what I want to have happen before I start an important Strongly Strongly
conversation. Disagree Agree

0 - 100
16) I am unclear about what is most important to me. Strongly Strongly
Disagree Agree
 PERSONAL EFFECTIVENESS QUOTIENT

Name: Date:

HABIT 3: PUT FIRST THINGS FIRST

0 - 100
17) I feel like I spend most of my time "putting out fires." Strongly Strongly
Disagree Agree

0 - 100
18) I work toward long-term solutions, not just "quick fixes." Strongly Strongly
Disagree Agree

0 - 100
19) Other people's urgencies and emergencies usually dominate my Strongly Strongly
day. Disagree Agree

0 - 100
20) I respect people's time (i.e., I do not waste others' time with trivial Strongly Strongly
interruptions). Disagree Agree

0 - 100
21) I have trouble saying no to other people's requests, even when Strongly Strongly
saying no is appropriate. Disagree Agree

0 - 100
22) I don't let my online activities interfere with my work or home Strongly Strongly
responsibilities. Disagree Agree

0 - 100
23) I rarely plan ahead and take each day as it comes. Strongly Strongly
Disagree Agree

0 - 100
24) I am usually on time (e.g., not late for appointments, meetings, etc.). Strongly Strongly
Disagree Agree

0 - 100
25) I often procrastinate. Strongly Strongly
Disagree Agree
 PERSONAL EFFECTIVENESS QUOTIENT

Name: Date:

EMOTIONAL BANK ACCOUNT

0 - 100
26) I acknowledge and apologize for mistakes. Strongly Strongly
Disagree Agree

0 - 100
27) I show appreciation for positive performance. Strongly Strongly
Disagree Agree

0 - 100
28) I rarely, if ever, talk about people behind their back. Strongly Strongly
Disagree Agree

0 - 100
29) I use social media to build people up, not to tear them down. Strongly Strongly
Disagree Agree

0 - 100
30) I have a hard time forgiving people. Strongly Strongly
Disagree Agree

0 - 100
31) I find it easy to find fault with others. Strongly Strongly
Disagree Agree

0 - 100
32) I have a hard time saying I am sorry. Strongly Strongly
Disagree Agree

0 - 100
33) I have a hard time keeping confidences. Strongly Strongly
Disagree Agree
 PERSONAL EFFECTIVENESS QUOTIENT

Name: Date:

HABIT 4: THINK WIN-WIN

0 - 100
34) I find it hard to share credit and recognition for successes. Strongly Strongly
Disagree Agree

0 - 100
35) I tend to have favorites (a clique or ingroup I prefer to work with). Strongly Strongly
Disagree Agree

0 - 100
36) I am often insensitive to other people’s feelings. Strongly Strongly
Disagree Agree

0 - 100
37) I anticipate how my decisions impact others. Strongly Strongly
Disagree Agree

0 - 100
38) I do what is best for the entire group, not just my own interests. Strongly Strongly
Disagree Agree

0 - 100
39) I have trouble getting to mutually agreeable solutions with other Strongly Strongly
people. Disagree Agree

0 - 100
40) I establish clear expectations when working with others. Strongly Strongly
Disagree Agree

0 - 100
41) I see myself as equal to those around me. Strongly Strongly
Disagree Agree
 PERSONAL EFFECTIVENESS QUOTIENT

Name: Date:

HABIT 5: SEEK FIRST TO UNDERSTAND, THEN TO BE UNDERSTOOD

0 - 100
42) I am easy to approach with a concern. Strongly Strongly
Disagree Agree

0 - 100
43) I tend to dominate discussions. Strongly Strongly
Disagree Agree

0 - 100
44) I listen to others without interrupting. Strongly Strongly
Disagree Agree

0 - 100
45) I usually become defensive when I receive negative feedback. Strongly Strongly
Disagree Agree

0 - 100
46) I am rarely interested in understanding other people's viewpoints. Strongly Strongly
Disagree Agree

0 - 100
47) I seek to understand problems before attempting to solve them. Strongly Strongly
Disagree Agree

0 - 100
48) I communicate clearly and respectfully. Strongly Strongly
Disagree Agree

0 - 100
49) I find it hard to ask for what I really want. Strongly Strongly
Disagree Agree
 PERSONAL EFFECTIVENESS QUOTIENT

Name: Date:

HABIT 6: SYNERGIZE

0 - 100
50) I seek out the strengths of others to get things done. Strongly Strongly
Disagree Agree

0 - 100
51) I am uncomfortable working with people who are different from me. Strongly Strongly
Disagree Agree

0 - 100
52) I build relationships with people outside my work group. Strongly Strongly
Disagree Agree

0 - 100
53) I am uncomfortable trying new ideas. Strongly Strongly
Disagree Agree

0 - 100
54) I encourage and support creativity and innovation. Strongly Strongly
Disagree Agree

0 - 100
55) I often find myself at odds with other people. Strongly Strongly
Disagree Agree

0 - 100
56) I regularly seek out people with different points of view. Strongly Strongly
Disagree Agree

0 - 100
57) My ego gets in the way when I feel threatened. Strongly Strongly
Disagree Agree
 PERSONAL EFFECTIVENESS QUOTIENT

Name: Date:

HABIT 7: SHARPEN THE SAW

0 - 100
58) I am competent in my field of work. Strongly Strongly
Disagree Agree

0 - 100
59) I care about others and try to build lasting friendships. Strongly Strongly
Disagree Agree

0 - 100
60) I don't care enough for my physical well-being. Strongly Strongly
Disagree Agree

0 - 100
61) I rarely seek feedback on ways I can improve. Strongly Strongly
Disagree Agree

0 - 100
62) I take steps to improve my unique talents and abilities. Strongly Strongly
Disagree Agree

0 - 100
63) I take time to find enjoyment and meaning in life. Strongly Strongly
Disagree Agree

0 - 100
64) I struggle to live a balanced life. Strongly Strongly
Disagree Agree

0 - 100
65) I feel like my skills are lagging behind the organization’s needs. Strongly Strongly
Disagree Agree