Leadership Impact Questionnaire

Thank you for taking the time to complete this Leadership Impact Questionnaire on behalf of the individual who shared it with you.  Please know that your feedback will be anonymous, and will be collated with all other feedback received.

To that end, be sure to fill in the name of the person you are completing this feedback for, NOT YOUR OWN NAME!

360 Review

  • Please complete this questionnaire. It is imperative that your response be received immediately so that your feedback is included in the report.
    If you have questions regarding this questionnaire, please call us at (336) 866-3747 (EQIQ) or get in contact here.
    Please click on the numerical response for each statement below.

    1 is the lowest rating and 7 the highest.

  • Competency

  • Integrity

  • Intimacy

  • Passion

  • The Courage to Lead

  • Note: Written feedback is key. Please take the time to complete this portion of the questionnaire.