Your Role & Relationships

Thank you for taking time to complete this survey. Your feedback is invaluable and will helps us assess how [PRACTICE NAME] is performing as an organization. All responses are strictly confidential and feedback will only be reviewed in an aggregate form (all of the data lumped together).

Please indicate whether you agree or disagree with the following statements.

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* 1. Which category best represents your role at [PRACTICE NAME]?

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* 2. Which team are you a part of at work? (please select all that apply)

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* 3. How happy or unhappy are you with your current role at [PRACTICE NAME]?

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* 4. At work, I clearly understand what is expected of me.

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* 5. I have the materials and equipment I need to do my work right.

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* 6. I have the chance to use my strengths every day at work.

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* 7. In the past seven days, I have received recognition or praise for good work.

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* 8. My supervisor, or someone at work, seems to care about me as a person.

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* 9. At work, my opinions seem to count.

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* 10. My teammates have my back.

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* 11. I have a best friend at work.

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* 12. In the past six months, someone at work has talked to me about my progress.

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* 13. In the past year, I have had opportunities at work to learn and grow.

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* 14. I am satisfied with the workplace culture at [PRACTICE NAME].

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* 15. I have great confidence in [PRACTICE NAME]'s future.

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