The purpose of this exercise is to identify gaps in your practice to help prioritize the
areas that need the most attention. There are a total of 36 questions. Each question
has 5 possible responses. You are asked to select one response for each question. To
truly benefit from this exercise, it is important that you answer all questions in terms
of what you actually think and/or do not what you believe is the right answer. So
please answer each question honestly.
Importance Level
Each statement below expresses the importance of some aspect of making a practice
effective. You are to decide how important you believe that statement to be. Then
circle the number that best represents your decision using the following scale:
5= Extremely important
4=Quite important
3=Somewhat important
2=Not very important
1= not at all important
Que
s.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
1
1
2
2
3
3
4
4
5
5
Performance Level
Each statement below describes the effective performance of some aspect of making
your practice effective. You are to decide how WELL you perform each item as
stated. Then circle the number that best represents your decision using the following
scale:
5= Extremely well
4=Quite well
3=Moderately well
2=So So
1= not at all well
Que
s.
19
20
21
22
23
24
25
26
27
28
29
1
1
2
2
3
3
4
4
5
5
30
31
32
33
34
35
36
Performan
ce
Importan
ce
GAP
Q19 score:
minus
Q1 score:
Q20 score:
minus
Q2 score:
Q21 score:
minus
Q3 score:
Q22 score
minus
Q4 score:
Q23 score:
minus
Q5 score:
Q24 score:
minus
Q6 score:
Q25 score:
minus
Q7 score:
regular basis.
Creating a structured week in
order to maximize your time on
revenue producing activities
Q26 score:
minus
Q8 score:
Q27 score
minus
Q9 score:
Q28 score:
minus
Q10 score:
Q29 score:
minus
Q11 score:
Q30 score:
minus
Q12 score:
Q31 score:
minus
Q13 score:
Q32 score:
minus
Q14 score:
Q33 score:
minus
Q15 score:
Q34 score:
minus
Q16 score:
Q35 score:
minus
Q17 score:
Q 36 score:
minus
Q18 score: