Intervention Consultation Questionnaire

Thank you in advance for filling out this questionnaire so that our time focuses on equipping you with the mindset, skills, and confidence to respond to challenging employees with calm composure and clear messages.

Allow yourself at least 15-20 minutes to complete the questionnaire. The length of time depends on the severity of your situation. 

The more detailed you are in your answers prepare us to develop a customized plan for you to intervene successfully and stop behaviors destroying your work culture.

This questionnaire is strictly confidential.

If we don't get a completed application from you at least 24 hours before your appointment, your Intervention Consultation may be canceled. 

Please answer all the questions. Here we GO...

Intervention Consultation Questionnaire

Please enter a number from 1 to 10.
If changes are not made, describe what is likely to happen if the challenges you're facing continue? Click all that apply:(Required)

Thank you for completing. 

Once I receive your questionnaire, you will receive a personal confirmation email from me (Bonnie).