Success Stories • Client List • Assessment • Contact Camille

Needs Assessment Form

Which of the following areas are ones in which you'd like to improve? Check as many as you like; but when you're finished, prioritize the #1 area for improvement. Then answer the questions at the bottom. If I were better at ? ; what would happen and what would be the value of that change ? Is the change worth the return? Contact Camille and discuss it in more detail.

CONTACT INFORMATION Name :
E-Mail :
Phone :

ASSESSMENT FORM

Teamwork	Communication	Follow-up
Listening Skills	Giving Feedback	Productivity
Personal Organization	Time Management	Leadership
Balancing Career and Family	Goal Setting and Tracking	Motivation
Problem Solving	Decision Making	Being Tough
Saying “No”	Dealing with Interruptions	Patience
Confidence	Persistence	Project Management
Strategic Planning	Dealing with Change	Planning
Using a Planner	Staying Focused	Prioritizing
Knowing What I Want	Producing Measurable Results	Delegation
Coaching	Selling/Selling my Ideas	Stress
Giving Clear Direction	Inter-personal Skills	Attitude
Procrastination	Stubborness/Hard-Headedness

If I were better at:
The result would be:
What is the value of that result?