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Company Name YOUR LOGO HERE Information About You My Supervisor: Disagree Neither Agree nor Disagree Agree 1. Treats me fairly 2. Brings out the best in employees 3. Treats me with respect 4. Takes initiative 5. Develops new strategies 6. Is skilled in conflict resolution 7. Is skilled in conflict resolution FEEDBACK ABOUT YOUR SUPERVISOR My Supervisor: Disagree Neither Agree nor Disagree Agree 33. Supports the use of technology to do my job 34. Establishes clear expectations 35. Provides the equipment I need to do my job well 36. Has a clear idea of my job responsibilities 37. Accepts constructive criticism 38. Leads by example 39. Offers me the flexibility I want 40. Provides me with adequate feedback 41. Holds me accountable for the work that I do 42. Rewards people according to their accomplishments 43. Sets challenging performance goals for my job 44. Evaluates all options before acting 45. Effectively resolves department conflicts 46. Is committed to organizational goals 47. Is an effective leader 48. Understands our needs 49. Communicates effectively 50. Develops innovative solutions 51. Is someone I trust 52. Sets a good example 53. Shows an eagerness to improve 54. Encourages my development 55. Inspires future success 56. Thinks before taking action My Supervisor: Disagree Neither Agree nor Disagree Agree 8. Handles my work-related 9. Builds loyalty in others 10. Tells me when my work needs improvement 11. Expects and demands superior job performance 12. Explores new and exciting opportunities 13. Challenges the abilities of other employees 14. Tells me when I do my work well 15. Asks me for my input to help make decisions 16. Gives good, practical advice 17. Communicates decisions with confidence 18. Is open-minded 19. Handles disruptive employees effectively 20. Is well informed 21. Effectively settles disciplinary problems 22. Usually rewards hard work 23. Recognizes when I do a good job 24. Encourages me to create innovative solutions 25. Allows me to develop professionally 26. Allows me to obtain necessary training 27. Helps me to feel secure in my job 28. Sets high standards for themselves 29. Provides the necessary resources to perform my job 30. Makes good use of my skills and abilities 31. Thinks through alternatives 32. Enables me to be more effective Department: Accounting Legal and Copyright Customer Service Payroll Finance Physical Plant Human Resources Research and Development Length: Less than one Year Five to nine years One to two years Ten to nineteen years Three to four years Twenty years or more Job Classification: Supervisor/manager Non-supervisory/eligible for overtime (non-exempt) Non-supervisory/not eligible for overtime (exempt) Director and above Temporary Clerical Staff