Organizational Assessment

1. Organizational Health Screening Tool

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Welcome. This is a brief organizational health screening tool designed by X Factor Consulting. This assessment provides an overview of some of the key areas of organizational management and is geared towards non-profit organizations. This tool helps us better understand your organization and jointly determine priorities for more in-depth assessment, training, consulting and/or coaching.

There are nine (9) pages of questions and should take less than 15 minutes to answer.

Please answer all of the questions as completely as possible. Someone from our staff will contact you soon.

1. Please enter your contact information.

Please enter your contact information. Name:
Address:
Address 2:
City/Town:
State:
ZIP:

2. Please enter your email address:

Please enter your email address:

3. Organization name:

Organization name:

4. In what year was the organization established?

In what year was the organization established?

5. What best describes your role in the organization?

What best describes your role in the organization? Executive Director Board Chair	Board Member Staff Member	Volunteer
Other (please specify)

6. Please tell us about your staff:

	None	1 - 5	6 - 10	11 - 25	More than 25
How many full-time employees does the organization employ?	Please tell us about your staff: How many full-time employees does the organization employ? None	1 - 5	6 - 10	11 - 25	More than 25
How many part-time employees does the organization employ?	How many part-time employees does the organization employ? None	1 - 5	6 - 10	11 - 25	More than 25

7. What is the annual operating budget for your organization?

What is the annual operating budget for your organization? < $50,000

$50,001 - $250,000

$250,001 - $500,000

$500,001 - $1,000,000

$1,000,000 - $5,000,000

> $5,000,000

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