Women’s Autonomy Alliance Present Position Survey

Women’s Autonomy Alliance Present Position Survey

There are no wrong answers.
Name

First NameLast Name
Please choose the answer for each statement indicating how well that statement describes you

Read each question or statement carefully and answer accordingly. The 1 through 5 may mean positive or negative.
How confident do you feel asserting your boundaries in social situations?

1

2

3

4

5

1 is Not at alll, 5 is Very
How confident are you with saying no to requests or demands you really don't want to do?

1

2

3

4

5

1 is Not at all, 5 is Very
Do you feel supported by your social circle?

1

2

3

4

5

1 is Not at all , 5 is Yes, always
Do you have established boundaries in place within your family, sociatal, and work groups?

1

2

3

4

5

1 is No, 5 is Yes
How often do you assert yourself when boundary limits are infringed upon?

1

2

3

4

5

1 is Never, 5 is Always
I always have the opportunity to react honestly to difficult situations.

1

2

3

4

5

1 is Never, 5 is Always
I have sought help or guidance to improve my autonomy or assertiveness.

1

2

3

4

5

1 is Never, 5 is Yes
Would you say it is a challenge to maintain your autonomy?

1

2

3

4

5

1 is Yes, 5 is Sometimes
I feel I have the skills I need to be more autonomous.

1

2

3

4

5

1 is Not at all, 5 is Yes
I don't need any help to improve my social skills.

1

2

3

4

5

1 is Disagree, 5 is Agree
How do you feel after standing up for yourself in a difficult situation?

1

2

3

4

5

1 is I can not , 5 is Fantastic
Do you agree with the following statement? My personal goals are taking care of themselves.

1

2

3

4

5

1 is Disagree, 5 is Agree
I can effectively handle unwanted advances.

1

2

3

4

5

1 is Not at all, 5 is Very
I can effectively handle unwanted obligations from family, friends or colleague.

1

2

3

4

5

1 is Not at all, 5 is Very
I can improved my skills in self-protection on my own.

1

2

3

4

5

1 is Not at all, 5 is I got this
Improving my autonomy skills would benefit my way of life for the better.

1

2

3

4

5

1 is Yes it would, 5 is It's fine now
Building my skills of self-protection would benefit my life for the better

1

2

3

4

5

1 is Absolutely , 5 is No different
I feel confident that being fair to myself first will improve my life.

1

2

3

4

5

1 is Absolutely , 5 is No different
I would feel better about my future endeavors with more confidence.

1

2

3

4

5

1 is Absolutely , 5 is No different
Should be Empty:

Women’s Autonomy Alliance Present Position Survey

Please choose the answer for each statement indicating how well that statement describes you