Likert Type Scale Form – Fill Out and Use This PDF

Level of Acceptability

My beliefs

Level of Support/Opposition

• 1 – Totally unacceptable

• 1 – Very untrue of what I believe

• 1 – Strongly oppose

•

2

– Unacceptable

• 2 – Untrue of what I believe

• 2 – Somewhat oppose

• 3 – Slightly unacceptable

• 3 – Somewhat untrue of what I

•

3

– neutral

•

4

– Neutral

believe

• 4 – Somewhat favor

• 5 – Slightly acceptable

•

4 – Neutral

• 5 – Strongly favor

•

6

– Acceptable

• 5 – Somewhat true of what I

• 7 – Perfectly Acceptable

believe

Level of Probability

• 6 – True of what I believe

• 1 – Not probable

Level of Appropriateness

• 7 – Very true of what I believe

• 2 – Somewhat improbable

• 1 – Absolutely inappropriate

•

3

– Neutral

•

2

– Inappropriate

Priority:

• 4 – Somewhat probable

• 3 – Slightly inappropriate

• 1 – Not a priority

• 5 – Very probable

•

4

– Neutral

• 2 – Low priority

• 5 – Slightly appropriate

• 3 – Somewhat priority

Level of Agreement

•

6

– Appropriate

•

4 – Neutral

• 1 – Strongly disagree

• 7 – Absolutely appropriate

• 5 – Moderate Priority

•

2

– Disagree

• 6 – High priority

• 3 – Neither agree or disagree

Level of Importance

• 7 – Essential priority

•

4

– Agree

• 1 – Not at all important

• 5 – Strongly agree

• 2 – Low importance

Level of Concern

• 3 – Slightly important

• 1 – not at all concerned

Level of Desirability

•

4

– Neutral

• 2 – Slightly concerned

• 1 – Very undesirable

• 5 – Moderately important

• 3 – Somewhat concerned

•

2

– Undesirable

• 6 – Very important

• 4 – Moderately concerned

•

3

– neutral

• 7 – Extremely important

• 5 – Extremely concerned

•

4

– Desirable

• 5 – Very desirable

Level of Agreement

Priority Level

• 1 – Strongly disagree

• 1 – Not a priority

Level of Participation

•

2

– Disagree

• 2 – Low priority

• 1 – No, and not considered

• 3 – Somewhat disagree

• 3 – Medium priority

• 2 – No, but considered

• 4 – Neither agree or

• 4 – High priority

•

3

– Yes

disagree

•

5 – Essential

• 5 – Somewhat agree

Frequency – 5 point

•

6

– Agree

Level of Problem

•

1

– Never

• 7 – Strongly agree

• 1 – Not at all a problem

•

2

– Rarely

• 2 – Minor problem

•

3

– Sometimes

Knowledge of Action

• 3 – Moderate problem

•

4

– Often

• 1 – Never true

• 4 – Serious problem

•

5

– Always

• 3 – Sometimes but

Affect on X

Frequency

infrequently true

• 1 – No affect

•

1 – Never

• 4

– Neutral

• 2

– Minor affect

•

2

– Rarely

• 5

– Sometimes true

• 3

– Neutral

•

3

– Occasionally

• 6

– Usually true

• 4

– Moderate affect

•

4

– A moderate amount

• 7

– Always true

• 5

– Major affect

•

5

– A great deal

Reflect Me?

Level of Consideration

Frequency of Use

• 1 – Very untrue of me

• 1

– Would not consider

•

1 – Never

• 2

– Untrue of me

• 2

– Might or might not consider

•

2

– Almost never

• 3

– Somewhat untrue of me

• 3

– Definitely consider

•

3

– Occasionally/Sometimes

• 4

– Neutral

•

4

– Almost every time

• 5

– Somewhat true of me

•

5

– Every time

Frequency – 7 point

Level of Difficulty

Level of Satisfaction – 5 point

•

1 – Never

• 1 – Very difficult

• 1 – Not at all satisfied

• 2 – Rarely, in less than 10%

•

2

– Difficult

• 2 – slightly satisfied

of the chances when I could

•

3

– Neutral

• 3 – moderately satisfied

have

•

4

– Easy

• 4 – Very satisfied

• 3 – Occasionally, in about

• 5 – Very easy

• 5 – Extremely satisfied

30% of the chances when I

could have

Likelihood

Level of Satisfaction – 7 point

• 4 – Sometimes, in about

• 1 – Extremely unlikely

• 1 – Completely dissatisfied

50% of the chances when I

•

2

– unlikely

• 2 – Mostly dissatisfied

could have

•

3

– Neutral

• 3 – Somewhat dissatisfied

• 5 – Frequently, in about 70%

•

4

– likely

• 4 – neither satisfied or

of the chances when I could

• 5 – Extremely likely

dissatisfied

have

• 5 – Somewhat satisfied

• 6 – Usually, in about 90% of

Level of Detraction

• 6 – Mostly satisfied

the chances I could have.

• 1 – detracted very little

• 7 – Completely satisfied

• 7 – Every time

•

2

–

•

3

– Neutral

Level of Quality – 5 point

Amount of Use

•

4

–

•

1 – Poor

• 1 – Never use

• 5 – Detracted very much

•

2 – Fair

• 2 – Almost never

•

3 – Good

•

3 – Occasionally/Sometimes

Good / Bad

• 4 – Very good

• 4 – Almost every time

• 1 – Very negative

•

5 – Excellent

• 5 – Frequently use

•

2

–

•

3

– Neutral

Comparison of Two Products

Level of Familiarity

•

4

–

• 1 – much worse

• 1 – not at all familiar

• 5 – Very positive

• 2 – somewhat worse

• 2 – Slightly familiar

• 3 – about the same

• 3 – Somewhat familiar

Barriers

• 4 – somewhat better

• 4 – Moderately familiar

• 1 – Not a barrier

• 5 – much better

• 5 – Extremely familiar

• 2 – Somewhat of a barrier

• 3 – Moderate barrier

Level of Responsibility

Level of Awareness

• 4 – Extreme barrier

• 1 – Not at all responsible

• 1 – not at all aware

• 2 – somewhat responsible

• 2 – Slightly aware

Level of Satisfaction – 5 point

• 3 – mostly responsible

• 3 – Somewhat aware

• 1 – Very dissatisfied

• 4 – completely responsible

• 4 – Moderately aware

•

2

– dissatisfied

• 5 – Extremely aware

•

3

– unsure

Level of Influence

•

4

– satisfied

• 1 – not at all influential

• 5 – Very satisfied

• 2 – slightly influential

• 3 – somewhat influential