[Company Name]

Information about You

DEPARTMENT

[Choose an item.]

JOB CLASSIFICATION

[Choose an item.]

LENGTH OF SERVICE

[Choose an item.]

FEEDBACK ABOUT YOUR SUPERVISOR

My supervisor	Feedback
Treats me fairly	[Choose an item.]
Brings out the best in employees	[Choose an item.]
Treats me with respect	[Choose an item.]
Takes initiative when solving problems	[Choose an item.]
Develops new strategies	[Choose an item.]
Applies policies and regulations fairly	[Choose an item.]
Is skilled in conflict resolution	[Choose an item.]
Handles my work-related issues satisfactorily	[Choose an item.]
Builds loyalty in others	[Choose an item.]
Tells me when my work needs improvement	[Choose an item.]
Expects and demands superior job performance	[Choose an item.]
Explores new and exciting opportunities	[Choose an item.]
Challenges the abilities of other employees	[Choose an item.]
Tells me when I do my work well	[Choose an item.]
Asks me for my input to help make decisions	[Choose an item.]
Gives good, practical advice	[Choose an item.]
Communicates decisions with confidence	[Choose an item.]
Is open-minded	[Choose an item.]
Handles disruptive employees effectively	[Choose an item.]
Is well informed	[Choose an item.]
Effectively settles disciplinary problems	[Choose an item.]
Usually rewards hard work	[Choose an item.]
Recognizes when I do a good job	[Choose an item.]
Encourages me to create innovative solutions	[Choose an item.]
Allows me to develop professionally	[Choose an item.]
Allows me to obtain necessary training	[Choose an item.]
Helps me to feel secure in my job	[Choose an item.]
Sets high standards for themselves	[Choose an item.]
Provides the necessary resources to perform my job	[Choose an item.]
Makes good use of my skills and abilities	[Choose an item.]
Thinks through alternatives	[Choose an item.]
Enables me to be more effective in my job	[Choose an item.]
Supports the use of technology to do my job	[Choose an item.]
Establishes clear expectations	[Choose an item.]
Provides the equipment I need to do my job well	[Choose an item.]
Has a clear idea of my job responsibilities	[Choose an item.]
Accepts constructive criticism	[Choose an item.]
Leads by example	[Choose an item.]
Offers me the flexibility I want	[Choose an item.]
Provides me with adequate feedback	[Choose an item.]
Holds me accountable for the work that I do	[Choose an item.]
Rewards people according to their accomplishments	[Choose an item.]
Sets challenging performance goals for my job	[Choose an item.]
Evaluates all options before acting	[Choose an item.]
Effectively resolves department conflicts	[Choose an item.]
Is committed to organizational goals	[Choose an item.]
Is an effective leader	[Choose an item.]
Understands our needs	[Choose an item.]
Communicates effectively	[Choose an item.]
Develops innovative solutions	[Choose an item.]
Is someone I trust	[Choose an item.]
Sets a good example	[Choose an item.]
Shows an eagerness to improve	[Choose an item.]
Encourages my development	[Choose an item.]
Inspires future success	[Choose an item.]
Thinks before taking action	[Choose an item.]

FEEDBACK ABOUT MANAGEMENT

management	Feedback
Brings out the best in employees	[Choose an item.]
Treats employees with fairness and respect	[Choose an item.]
Develops appropriate solutions	[Choose an item.]
Identifies root causes of problems	[Choose an item.]
Treats employees with respect	[Choose an item.]
Demonstrates that employees are important to the success of the organization	[Choose an item.]
Provides a clear picture of where the organization is headed	[Choose an item.]
Can be trusted to make sensible decisions for the organization	[Choose an item.]
Practices what they preach	[Choose an item.]
Inspires future success	[Choose an item.]
Encourages my development	[Choose an item.]
Shows an eagerness to improve	[Choose an item.]
Sets a good example	[Choose an item.]
Develops innovative solutions	[Choose an item.]
Communicates effectively	[Choose an item.]
Understands our needs	[Choose an item.]
Is committed to organizational goals	[Choose an item.]
Effectively resolves department conflicts	[Choose an item.]
Evaluates all options before acting	[Choose an item.]
Sets challenging performance goals	[Choose an item.]
Rewards people according to their accomplishments	[Choose an item.]
Holds employees accountable for the work that they do	[Choose an item.]
Provides me with adequate feedback	[Choose an item.]
Offers me the flexibility I want	[Choose an item.]
Leads by example	[Choose an item.]
Accepts constructive criticism	[Choose an item.]
Has a clear idea of my job responsibilities	[Choose an item.]
Provides the equipment I need to do my job well	[Choose an item.]
Establishes clear expectations	[Choose an item.]
Supports the use of technology in the workplace	[Choose an item.]
Enables me to be more effective in my job	[Choose an item.]
Thinks through alternatives	[Choose an item.]
Makes good use of my skills and abilities	[Choose an item.]
Provides the necessary resources to perform my job	[Choose an item.]
Sets high standards for others	[Choose an item.]
Sets high standards for themselves	[Choose an item.]
Allows me to obtain necessary training	[Choose an item.]
Supports my professional development	[Choose an item.]
Encourages creative and innovative solutions	[Choose an item.]
Recognizes when I do a good job	[Choose an item.]
Effectively settles disciplinary problems	[Choose an item.]
Is well informed	[Choose an item.]
Handles disruptive employees effectively	[Choose an item.]
Is open-minded	[Choose an item.]
Communicates decisions with confidence	[Choose an item.]
Gives good, practical advice	[Choose an item.]
Asks for my input to help make decisions	[Choose an item.]
Recognizes employees for good work	[Choose an item.]
Challenges the abilities of employees	[Choose an item.]
Explores new and exciting opportunities	[Choose an item.]
Expects and demands superior job performance	[Choose an item.]
Evaluates performance of administrative functions	[Choose an item.]
Fosters loyalty in employees	[Choose an item.]
Applies policies and regulations fairly	[Choose an item.]
Develops new strategies	[Choose an item.]
Considers innovative solutions to problems	[Choose an item.]

Your comments

What is lacking in your work environment that might help you perform better? [Response]
What would make our organization more effective? [Response]