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Instructions: Carefully read each numbered item and its statements marked "A" and "B." Assign a point value to the A and B statements as follows: The total point value for A and B added together is five (5). If statement A is most similar to what you would do, mark 5 for A and 0 for B. If A is not wholly satisfactory, but in your judgment better than B, mark 4 or 3 for A and 1 or 2 for B. The converse is true: if B is best mark 5 for B and 0 for A and so on.
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On the top line of the graph below, mark your score for Solicits Feedback, then draw a vertical line downward. On the left line of the graph below, mark your score for Willingness to Self- Disclose/Gives Feedback, then draw a line across horizontally (left to right).