Form

Name

First NameLast Name

Email

Occupation

Years on the job and do you like your job?

This is to show you (by the answers chosen) how you use your voice at
work. Colors reflect how strongly you speak at work.
*Choose a color that you feel represents how well you speak at work

• Orange = Quiet: I am very shy
• Blue = Outspoken: I love to speak up when I have something to say
• Red = Nervous: the men may laugh at what I have to say
• Green = It depends on who is in the room as to whether I speak up
or not
• Pink = I imagine what I would say but I never say it
• Purple = I will speak up but I will never go first in asking a question
or making a comment
• Yellow = My voice is none of these colors
• Other = Write in what color your voice is to you if you do not see it
listed above

Questions

Q1: In front of your male coworkers, do you speak up for yourself and the quality of your work?

What Color

Q2: When I am in a meeting with male colleagues, I am

What Color

Q3: When my boss is giving me feedback about the quality of my work, I

Choose a color

Q4: If my suggestion is dismissed and 10 minutes later a male colleague gives the same suggestion and the suggestion is acknowledged, I

Choose a color

Q5: Are you satisfied with the color of your voice overall?

YesNo

Q6: Do you want to improve the way you use your voice in front of men at work? Would you like to achieve better results when you speak?

YesNo