[Company Name]

Engagement
Survey
Template
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
1. Treats me fairly [Choose an item.]
2. Brings out the best in employees [Choose an item.]
3. Treats me with respect [Choose an item.]
4. Takes initiative when solving problems [Choose an item.]
5. Develops new strategies [Choose an item.]
6. Applies policies and regulations fairly [Choose an item.]
7. Is skilled in conflict resolution [Choose an item.]
8. Handles my work-related issues satisfactorily [Choose an item.]
9. Builds loyalty in others [Choose an item.]
10. Tells me when my work needs improvement [Choose an item.]
11. Expects and demands superior job performance [Choose an item.]
12. Explores new and exciting opportunities [Choose an item.]
13. Challenges the abilities of other employees [Choose an item.]
14. Tells me when I do my work well [Choose an item.]
15. Asks me for my input to help make decisions [Choose an item.]
16. Gives good, practical advice [Choose an item.]
17. Communicates decisions with confidence [Choose an item.]

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My supervisor Feedback
18. Is open-minded [Choose an item.]
19. Handles disruptive employees effectively [Choose an item.]
20. Is well informed [Choose an item.]
21. Effectively settles disciplinary problems [Choose an item.]
22. Usually rewards hard work [Choose an item.]
23. Recognizes when I do a good job [Choose an item.]
24. Encourages me to create innovative solutions [Choose an item.]
25. Allows me to develop professionally [Choose an item.]
26. Allows me to obtain necessary training [Choose an item.]
27. Helps me to feel secure in my job [Choose an item.]
28. Sets high standards for themselves [Choose an item.]
29. Provides the necessary resources to perform my job [Choose an item.]
30. Makes good use of my skills and abilities [Choose an item.]
31. Thinks through alternatives [Choose an item.]
32. Enables me to be more effective in my job [Choose an item.]
33. Supports the use of technology to do my job [Choose an item.]
34. Establishes clear expectations [Choose an item.]
35. Provides the equipment I need to do my job well [Choose an item.]
36. Has a clear idea of my job responsibilities [Choose an item.]
37. Accepts constructive criticism [Choose an item.]
38. Leads by example [Choose an item.]
39. Offers me the flexibility I want [Choose an item.]
40. Provides me with adequate feedback [Choose an item.]
41. Holds me accountable for the work that I do [Choose an item.]
42. Rewards people according to their accomplishments [Choose an item.]
43. Sets challenging performance goals for my job [Choose an item.]
44. Evaluates all options before acting [Choose an item.]
45. Effectively resolves department conflicts [Choose an item.]
46. Is committed to organizational goals [Choose an item.]
47. Is an effective leader [Choose an item.]
48. Understands our needs [Choose an item.]
49. Communicates effectively [Choose an item.]
50. Develops innovative solutions [Choose an item.]
51. Is someone I trust [Choose an item.]
52. Sets a good example [Choose an item.]
53. Shows an eagerness to improve [Choose an item.]
54. Encourages my development [Choose an item.]
55. Inspires future success [Choose an item.]

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My supervisor Feedback
56. Thinks before taking action [Choose an item.]

FEEDBACK ABOUT MANAGEMENT

management Feedback
1 Brings out the best in employees [Choose an item.]
57. Treats employees with fairness and respect [Choose an item.]
58. Develops appropriate solutions [Choose an item.]
59. Identifies root causes of problems [Choose an item.]
60. Treats employees with respect [Choose an item.]
61. Demonstrates that employees are important to the success of [Choose an item.]
the organization
62. Provides a clear picture of where the organization is headed [Choose an item.]
63. Can be trusted to make sensible decisions for the organization [Choose an item.]
64. Practices what they preach [Choose an item.]
65. Inspires future success [Choose an item.]
66. Encourages my development [Choose an item.]
67. Shows an eagerness to improve [Choose an item.]
68. Sets a good example [Choose an item.]
69. Develops innovative solutions [Choose an item.]
70. Communicates effectively [Choose an item.]
71. Understands our needs [Choose an item.]
72. Is committed to organizational goals [Choose an item.]
73. Effectively resolves department conflicts [Choose an item.]
74. Evaluates all options before acting [Choose an item.]
75. Sets challenging performance goals [Choose an item.]
76. Rewards people according to their accomplishments [Choose an item.]
77. Holds employees accountable for the work that they do [Choose an item.]
78. Provides me with adequate feedback [Choose an item.]
79. Offers me the flexibility I want [Choose an item.]
80. Leads by example [Choose an item.]
81. Accepts constructive criticism [Choose an item.]
82. Has a clear idea of my job responsibilities [Choose an item.]
83. Provides the equipment I need to do my job well [Choose an item.]
84. Establishes clear expectations [Choose an item.]
85. Supports the use of technology in the workplace [Choose an item.]
86. Enables me to be more effective in my job [Choose an item.]
87. Thinks through alternatives [Choose an item.]

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management Feedback
88. Makes good use of my skills and abilities [Choose an item.]
89. Provides the necessary resources to perform my job [Choose an item.]
90. Sets high standards for others [Choose an item.]
91. Sets high standards for themselves [Choose an item.]
92. Allows me to obtain necessary training [Choose an item.]
93. Supports my professional development [Choose an item.]
94. Encourages creative and innovative solutions [Choose an item.]
95. Recognizes when I do a good job [Choose an item.]
96. Effectively settles disciplinary problems [Choose an item.]
97. Is well informed [Choose an item.]
98. Handles disruptive employees effectively [Choose an item.]
99. Is open-minded [Choose an item.]
100. Communicates decisions with confidence [Choose an item.]
101. Gives good, practical advice [Choose an item.]
102. Asks for my input to help make decisions [Choose an item.]
103. Recognizes employees for good work [Choose an item.]
104. Challenges the abilities of employees [Choose an item.]
105. Explores new and exciting opportunities [Choose an item.]
106. Expects and demands superior job performance [Choose an item.]
107. Evaluates performance of administrative functions [Choose an item.]
108. Fosters loyalty in employees [Choose an item.]
109. Applies policies and regulations fairly [Choose an item.]
110. Develops new strategies [Choose an item.]
111. Considers innovative solutions to problems [Choose an item.]

YOUR COMMENTS

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What is lacking in your work environment that might help you perform better?
[Response]

What would make our organization more effective?

[Response]

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