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Service-Detox Questionnaire & Booking Form
Thank you for taking the time to fill out our Questionnaire & Booking Form. This is an important step in clarifying what you need, where to focus and how to get the right solution for you. Above all, remember that your answers to the following questions are an important part of understanding how you and your network can do better and beat the competition.

Some of the answers here are short and some will require more written content. Since communication is one of the most powerful competencies when it comes to Service Network Leadership, one of our assumptions is that in order to improve your life requires the ability to understand and articulate what is happening in our lives.

Your information will be treated with the utmost confidentiality and we will not share your results with any third party.

Thank you very much.

- Ran

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Ran Elfassy
Director, Service Detox Consulting
Email address *
Please provide your name and surname: *
Your answer
Please provide your daytime phone number (with country code): *
Your answer
Which of these areas would you like to improve: *
Required
Describe your personal and organizational context and conditions (professional experience, sector, company size, and impact on your clients' lives). *
Your answer
When mistakes happen on the job, what is your/your leaders' attitude toward deconstructing, understanding and sharing those failures with others? *
Your answer
Do you know your beliefs, attitudes and behaviors well enough to judge how you come across to others? What are the toxic or viral defects in your behaviors that you would like to address? *
Your answer
Do you have a clear understanding of your moral code and the importance of doing the right thing? How would you rate this awareness across the people in your networks? *
Yes
No
Do you understand what makes you tick well enough to consistently do the right thing – especially when it's the hard thing? *
Yes
No
How do you rate the people around you when it comes to valuing intellectual humility and discouraging leadership arrogance? *
Strong
Weak
What do you really care about and how does this manifest across your life? *
Your answer
What are the areas in your life that need improvement for you to succeed (i.e. if I was a genie who could help you turn any weakness into a strength, what would that be)? *
Your answer
Please rate the following statement: I am the kind of person who invests in my own self-improvement through continuous learning. *
Agree
Disagree
A copy of your responses will be emailed to the address you provided.
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