Assertiveness Survey Assertiveness Survey Using the following scale from Always - Often - Seldom - Never, rate each statement by click the scale that best typifies your behavior at work. Be honest! There are no right or wrong answers. Name * Work Unit * Phone * Email * 1. When I am not happy about a situation, I drop hints to other people about my feelings. * Always Often Seldom Never 2. If I realize the person to whom I am speaking is not listening, I stop talking. * Always Often Seldom Never 3. When I am not sure how to do a task, I feel comfortable asking for assistance. * Always Often Seldom Never 4. When someone does not agree with what I am saying, I raise my voice to make my point. * Always Often Seldom Never 5. I feel embarrassed when someone compliments me. * Always Often Seldom Never 6. I let my boss know when I disagree with him/her. * Always Often Seldom Never 7. I like to be in control of a situation. * Always Often Seldom Never 8. When someone takes advantage of me, I find a way to even the score. * Always Often Seldom Never 9. When I disagree with someone, I give them the silent treatment. * Always Often Seldom Never 10. I feel guilty when I have to ask others for help. * Always Often Seldom Never 11. I express my opinion to others in an honest and direct way when it is appropriate to do so. * Always Often Seldom Never 12. I tell other people when they have done something wrong. * Always Often Seldom Never 13. If I don’t agree with a task that I have been given, I procrastinate in doing it. * Always Often Seldom Never 14. I prefer to comply with the majority decision, even if it is not convenient for me. * Always Often Seldom Never 15. If one of my colleagues is more knowledgeable than I am, I call on them for advice or information. * Always Often Seldom Never 16. I can be sarcastic to my colleagues. * Always Often Seldom Never 17. I don’t like telling people my honest opinion if I think it will hurt their feelings. * Always Often Seldom Never 18. I believe I have the right to say “no” to other people’s requests and to negotiate a compromise. * Always Often Seldom Never 19. I am not afraid to be rude to other people. * Always Often Seldom Never 20. My anger tends to be explosive. * Always Often Seldom Never Submit If you are human, leave this field blank.
