Intake questionnaire

Please complete the questionnaire. It wil help you and your sparring partner get a clear view of what you want to achieve in your discussion.

Questionnaire

Name *

E-mail address *

Age (we would like to determine whether your age has an influence)

Profession

Your sparring partner *

Angely Beekman Anton Janssen Bart van de Goor Catherine Koster Dette Glashouwer Elif Özer Ellen van den Ouweland Gerdine Kuggeleijn Hanan Laghmouchi Ineke Peeters Ingrid Aarts Iris Steenbruggen Iris van Dongen Jeroen Windhorst Lucienne Scholten Maarten Siemerink Marjan ter Laan Martine Kennis Michael Meesters Tineke van Spaandonk Vera Feijer I would like you to call me before I choose a discussion partner

In broad terms, what do you want to say and to whom?

What is your goal? *

Specifically, what sentence(s) would you like to say to achieve this goal?

To whom specifically do you want to say this sentence(s)?

What does the setting look like?

What are important characteristics of the surroundings?

Are there other people there? Where do they sit/stand?

What social rules play a role?

Describe as realistically as possible the arrangement of the discussion in the room. Also indicate which attendants are in which position.

When are you going to say your straight talk sentences?

What day and what time? At what point the conversation

I agree to the privacy policy *

Contact

Would you like to know what Rechtdoorzee can do for you? Or would you like to discover what could be done differently? Let us know via info@rechtdoorzee.nu or
+31 (0)6 14 62 99 94

Address
St. Annastraat 174, 6524 GT Nijmegen