SELF ASSESSMENT – STAKEHOLDER SCORE

What company/organization are you assessing?

Which of the following best describes your relationship to the company or the perspective from which you will be completing this survey?

How much do you agree with the following statements?

For each statement:
1 = completely disagree
2 = somewhat disagree
3 = neutral
4 = somewhat agree
5 = completely agree
(leave blank if not applicable)

I believe this company could have a significant impact on me (e.g. my health, personal/professional interests, career, finances, quality of life).

I believe I could have a significant impact on this company (e.g. its financial performance, sustainability, reputation).

Collaborative Relationships

Overview: The company builds trusting relationships that meet the needs of everyone involved.

For each statement:
1 = completely disagree
2 = somewhat disagree
3 = neutral
4 = somewhat agree
5 = completely agree
(leave blank if not applicable)

The company is transparent and proactive in sharing information that is important to me.

The company takes my opinion seriously.

The company makes it safe for me to share an unpopular opinion about what it does.

Use the space below if you’d like to explain your scores for this section.

Helping People Thrive

Overview: The company helps people grow to fulfill their potential and live their best life for themself and their loved ones.

For each statement:
1 = completely disagree
2 = somewhat disagree
3 = neutral
4 = somewhat agree
5 = completely agree
(leave blank if not applicable)

The company supports my health and wellbeing at work.

The company supports my health and wellbeing outside of work (with my family and loved ones)

I feel valued by the company.

The company actively helps me reach my goals.

Use the space below if you’d like to explain your scores for this section.

Inclusion and Equity

Overview: The company proactively engages people from different backgrounds, identities, abilities and socio-economics to make better decisions.

For each statement:
1 = completely disagree
2 = somewhat disagree
3 = neutral
4 = somewhat agree
5 = completely agree
(leave blank if not applicable)

Within the company, a diverse group of people make key company decisions.

The people financially benefiting from the company fairly reflects the diversity of everyone they affect.

Company leaders are as diverse as the people they impact (customers, suppliers, community members, etc.).

Use the space below if you’d like to explain your scores for this section.

Financial Prosperity

Overview: The company strives to help everyone who works with them achieve financial security.

For each statement:
1 = completely disagree
2 = somewhat disagree
3 = neutral
4 = somewhat agree
5 = completely agree
(leave blank if not applicable)

I am confident in the long-term success of the company.

The value I get from the company is fair relative to the value I give.

My compensation allows me to meet my basic needs.

Over time, working with this company will allow me to reach my long-term financial goals.

Use the space below if you’d like to explain your scores for this section.

Environmental Stewardship

Overview: The company conserves and restores the environment as it does its business.

For each statement:
1 = completely disagree
2 = somewhat disagree
3 = neutral
4 = somewhat agree
5 = completely agree
(leave blank if not applicable)

The company considers and addresses its impact on the environment.

The company inspires me to take better care of the environment.

The company is helping to heal and restore the planet's life-support systems.

Use the space below if you’d like to explain your scores for this section.

Company Purpose

Overview: The company’s reason for being is to solve a specific, important problem.

For each statement:
1 = completely disagree
2 = somewhat disagree
3 = neutral
4 = somewhat agree
5 = completely agree
(leave blank if not applicable)

The company’s actions are consistently ethical.

I am inspired and motivated by the company's purpose.

The company’s actions are aligned with its purpose.

The company uses meaningful metrics to show its progress in fulfilling its purpose.

Use the space below if you’d like to explain your scores for this section.

Final Thoughts

Thank you for your responses. Finally, we’d like to ask you a couple more questions to see how you think your perspective compares to other people from your same stakeholder group. We’d also like to give you the opportunity to say anything else you’d like to say about your company and about this survey.

Do you think your personal experience with this company is similar to others?

I believe my experience is worse than others
I believe my experience is similar to others
I believe my experience is better than others
I'm not sure

What else would you like company leaders to know?

What is working about this tool and how can we make it better?

Email *

Would you like to apply for a company-wide assessment?

Company Assessment Application

We recommend starting your Stakeholder Score Assessment by surveying people who are familiar with the company's operations (e.g key investors/advisors, board members, leadership, and employees). Our team will be in touch to confirm the details of your assessment and provide you with a customized version of the survey for your company.

The cost of the assessment is based on the number of survey responses (excluding any incomplete surveys that are left out of the report):

<200 responses = $500
200-499 responses = $1000
500-999 responses = $2000
1000-1999 responses = $4000
>2000 responses = custom pricing

Company Contact Name *

First

Last

Company Name

Company Website URL

Relationship to Company Being Assessed

I am a consultant or contractor hired by the company being assessed.
I am employed by the company being assessed.
Other