Climate Survey.

Please fill out the information requested below. This will be used for us to better understand and assist ensuring you, or your team, meet the objectives they seek.

Name

First Name

Last Name

Phone

(###)

###

####

How would you describe your current conflict?

How and when did the conflict(s) begin?

Who is impacted by it?

What’s been done to address the conflict?

What hasn’t been done to address the conflict?

What are the sources of resistance?

What behavior do you want to change?

There is strong desire to make changes necessary to resolve the conflict?

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

Training Dynamics

In this section, please provide information for the composition and logistics of the requested event.

Number of participants.

Length of Training

Duration of training per day.

Method of training.

Please how you would like to have this training delivered.