Name ________________________________________Date ___________________
This completely confidential form is designed to help you gain clarity on various aspects of your integrity. Please complete the self-assessment portion, and then complete it again from the perspective of others with whom you associate closely.
Please be honest. No one will see this but you. Place a check-mark in one of the boxes on the right, with:
“5” being “I do this always,”
“4” being “almost always,”
3 being “often,”
“2” being “occasionally,” and
“1” being “I rarely do this.”
And remember, 5 – “always” -- means “always” !!
Now, step 2. How would others rate you on these same items? Remember to be honest. You
are the only person who will see this.
Dr. Henry Cloud in his book, Integrity: The Courage to Meet the Demands of Reality, states that integrity is “the key to success.” He continues, “A person with integrity has the – often rare – ability to pull everything together, to make it all happen no matter how challenging the circumstances.” Integrity defines our character, and our character can help us achieve
everything we would like to in our lives, or it can prevent us from being all we want or could be.
People with integrity “finish well.”
So, how do others see you and your level of integrity? Please use the same 1 to 5 scoring system as on the above self assessment.
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