BREAKTHROUGH - WORKLOAD PROGRAM - REGISTRATION FORM Survey

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4. Your preferred physical address (for delivery of your program kit and other resources provided throughout your program) (Not PO Box)

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5. Who is paying for your program?

I am. Please invoice me directly the full amount of $1200 + GST

I am. Please invoice me monthly in advance $400 + GST per month

Work is paying - please see email address for the invoice below:

Work Invoicing: Please provide the email address:

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6. Please take a moment to reflect on and complete the questions below. This provides Tanya with helpful information so she can best support you during the program: (Required.)

	Never	Occasionally	Regularly
I have a high volume of work	I have a high volume of work Never	I have a high volume of work Occasionally	I have a high volume of work Regularly
I have short time frames to complete my work tasks	I have short time frames to complete my work tasks Never	I have short time frames to complete my work tasks Occasionally	I have short time frames to complete my work tasks Regularly
I have competing demands	I have competing demands Never	I have competing demands Occasionally	I have competing demands Regularly
I experience changing priorities	I experience changing priorities Never	I experience changing priorities Occasionally	I experience changing priorities Regularly
My work is high in Intensity (complex, requires deep thinking)	My work is high in Intensity (complex, requires deep thinking) Never	My work is high in Intensity (complex, requires deep thinking) Occasionally	My work is high in Intensity (complex, requires deep thinking) Regularly
My work is stimulating or exciting	My work is stimulating or exciting Never	My work is stimulating or exciting Occasionally	My work is stimulating or exciting Regularly
I get to work on things that I enjoy	I get to work on things that I enjoy Never	I get to work on things that I enjoy Occasionally	I get to work on things that I enjoy Regularly
I receive push back if I raise concerns about my work volume	I receive push back if I raise concerns about my work volume Never	I receive push back if I raise concerns about my work volume Occasionally	I receive push back if I raise concerns about my work volume Regularly
I rely on others doing their job, to get my work completed	I rely on others doing their job, to get my work completed Never	I rely on others doing their job, to get my work completed Occasionally	I rely on others doing their job, to get my work completed Regularly
Others rely on me doing my job, to get their work completed	Others rely on me doing my job, to get their work completed Never	Others rely on me doing my job, to get their work completed Occasionally	Others rely on me doing my job, to get their work completed Regularly
My work is emotionally demanding (trauma, complex social or wellbeing issues)	My work is emotionally demanding (trauma, complex social or wellbeing issues) Never	My work is emotionally demanding (trauma, complex social or wellbeing issues) Occasionally	My work is emotionally demanding (trauma, complex social or wellbeing issues) Regularly
I feel energised by the work I do	I feel energised by the work I do Never	I feel energised by the work I do Occasionally	I feel energised by the work I do Regularly
I look forward to coming to work	I look forward to coming to work Never	I look forward to coming to work Occasionally	I look forward to coming to work Regularly

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7. To what degree does your current workload level impact your wellbeing? (Work stress, home/life balance, worry)

Not at all

It impacts a little

It has a big impact

Clear

i We adjusted the number you entered based on the slider’s scale.

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8. What are you hoping to get out of the BREAKTHROUGH program?

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9. Which of these strategies have you previously tried in managing your workload (tick all that apply).

Negotiating priorities with my leader

Delegating

Using time management models (Eisenhower/Covey matrix for e.g.)

Email management strategies - i.e. 4D system or other

Flexible work aligned to your best working time (early bird, night owl)

Protected time (shutting my door, blocking out time in my diary, putting FOCUS time blocks in my diary)

Working on my assertiveness skills to be able to say "no"

Strengthening my boundaries so I don't work too many overtime hours

Turning off notifications on phone and emails so they don't distract me

Removing emails from my home phone so I don't check them when I'm home

Coming in earlier to work when it is quieter

Prioritising - via To Do list, or digital tool such as Trello or One Note

Actively looking at what I can reduce or remove from my tasks

Other

BREAKTHROUGH - WORKLOAD PROGRAM - REGISTRATION FORM

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1. Your full name

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2. Your preferred daytime contact number

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3. Your preferred email address

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4. Your preferred physical address (for delivery of your program kit and other resources provided throughout your program) (Not PO Box)

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5. Who is paying for your program?

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6. Please take a moment to reflect on and complete the questions below. This provides Tanya with helpful information so she can best support you during the program: (Required.)

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7. To what degree does your current workload level impact your wellbeing? (Work stress, home/life balance, worry)

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8. What are you hoping to get out of the BREAKTHROUGH program?

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9. Which of these strategies have you previously tried in managing your workload (tick all that apply).

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10. What is your biggest concern in regard to your workload management?

BREAKTHROUGH - WORKLOAD PROGRAM - REGISTRATION FORM

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* 1. Your full name

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* 2. Your preferred daytime contact number

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* 3. Your preferred email address

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* 4. Your preferred physical address (for delivery of your program kit and other resources provided throughout your program) (Not PO Box)

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* 5. Who is paying for your program?

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* 6. Please take a moment to reflect on and complete the questions below. This provides Tanya with helpful information so she can best support you during the program: (Required.)

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* 7. To what degree does your current workload level impact your wellbeing? (Work stress, home/life balance, worry)

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* 8. What are you hoping to get out of the BREAKTHROUGH program?

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* 9. Which of these strategies have you previously tried in managing your workload (tick all that apply).

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* 10. What is your biggest concern in regard to your workload management?

1. Your full name

2. Your preferred daytime contact number

3. Your preferred email address

4. Your preferred physical address (for delivery of your program kit and other resources provided throughout your program) (Not PO Box)

5. Who is paying for your program?

6. Please take a moment to reflect on and complete the questions below. This provides Tanya with helpful information so she can best support you during the program: (Required.)

7. To what degree does your current workload level impact your wellbeing? (Work stress, home/life balance, worry)

8. What are you hoping to get out of the BREAKTHROUGH program?

9. Which of these strategies have you previously tried in managing your workload (tick all that apply).

10. What is your biggest concern in regard to your workload management?