Personal Values Survey Template

A word such as curiosity, fairness or care can mean different things to different people. This SurveyLegend example leaves room to define a value in your own words, consider where it mattered recently, and notice what might support a small action.

Use this questionnaire for voluntary adult reflection, not screening or judging participants. Unlike an annual resolution survey , it can be used at any time and starts with the participant’s own guiding principle rather than a list of goals to endorse.

Eyal and colleagues’ 2009 experiments found that the relationship between values and behavioral intentions varied with time perspective and how the situation was described. Their values and intentions study informs the distinction here between a general value and a feasible near-term action. It does not show that completing this questionnaire changes behavior. The questions are an original reflection aid, not a standardized values scale.

Choose one personal value or guiding principle you would like to reflect on. You may use your own words. Think about the past 30 days and one possible step in the next seven days. Every question is optional. Share only what you are comfortable sharing; do not include identifying details about other people.

Let participants name their own principle without supplying a preferred answer. If using this in a workshop, explain who can see submitted answers before inviting anyone to respond. Offer private paper reflection instead of collection when personal disclosure is unnecessary. Do not promise anonymity without checking the actual setup.

Keep written prompts neutral and allow every item to be skipped. SurveyLegend’s discussion of open-ended questions can help a facilitator leave space for participants’ own meaning. Do not repurpose responses for hiring, performance review, political targeting or mental-health assessment.

Copy this prompt into an AI assistant to draft the questions. Review the draft, then build and customize the survey in SurveyLegend before sharing.

Review the participant’s definition before interpreting any chosen rating. A value is not a fixed personality label, and the frequency of opportunities to act on it is not a measure of moral character. Limited time, responsibilities or resources may explain a gap between importance and action.

Use the chosen obstacle and support to make the next step more workable. If the action is too large for seven days, the participant can reduce its scope or choose a different step. Do not add answers into a score or compare people by the values they name. In a voluntary group, summarize only appropriately shared themes without identifying quotations. A later check-in can ask what happened; this questionnaire records a plan, not proof of follow-through.