Introduction
In keeping with [Company Name]’s goal to continuously improve, we are asking for your candid feedback on the performance of your manager this past year. A summary of all feedback received will be prepared for each individual manager so that he or she can use the feedback to learn and develop as a manager. Your individual feedback will be averaged into all the responses received in order to protect your anonymity and ensure that the results each manager receives are completely confidential. HR will also prepare an overall summary to assess areas for additional company-provided management training.
Thank you for your contribution to this very important process.
Name of Manager:_________________________________________________
Completed by (optional):____________________________________________
Date: __________________
Instructions
Using the following rating scale, please circle the number that best reflects your rating of your manager’s performance during the past year.
| Rating Scale | |
| 1 | Unacceptable |
| 2 | Needs improvement |
| 3 | Meets standard |
| 4 | Exceeds standard |
| 5 | Outstanding |
| 6 | Have not experienced or observed |
| Valuing Behaviors | |
| Seeks input from all team members | 1 2 3 4 5 6 |
| Measures results instead of individual styles | 1 2 3 4 5 6 |
| Maintains a balance between "people" issues and "business" issues | 1 2 3 4 5 6 |
| Shows genuine concern for team members | 1 2 3 4 5 6 |
| Keeps the focus on fixing problems rather than finding someone to blame | 1 2 3 4 5 6 |
Treats people fairly, without showing favoritism | 1 2 3 4 5 6 |
Cares about me | 1 2 3 4 5 6 |
| Protects confidentiality | 1 2 3 4 5 6 |
Recognizes and rewards my individual contributions in a manner meaningful to me | 1 2 3 4 5 6 |
| Interdependent Behaviors | |
| Supports a team environment by recognizing and rewarding collaboration, cooperation and activities contributing to others' success | 1 2 3 4 5 6 |
| Recognizes and rewards team-supportive actions and behaviors | 1 2 3 4 5 6 |
| Doesn't criticize those who are not present | 1 2 3 4 5 6 |
| Considers the impact of actions and decisions on other departments before implementing | 1 2 3 4 5 6 |
| Recognizes and supports the work of other departments | 1 2 3 4 5 6 |
| Communication Behaviors | |
| Encourages others to express different ideas and perspectives | 1 2 3 4 5 6 |
| Is open to other perspectives and is willing to change his or her position when presented with compelling information | 1 2 3 4 5 6 |
| Is open to negative and/or constructive feedback | 1 2 3 4 5 6 |
| Keeps me informed on the status of my work and updates in the organization | 1 2 3 4 5 6 |
| Gives open and constructive feedback | 1 2 3 4 5 6 |
| Effectively deals with conflict | 1 2 3 4 5 6 |
| Lets me know how I am doing | 1 2 3 4 5 6 |
| Involves me in decision-making when appropriate | 1 2 3 4 5 6 |
Sets a clear direction for our department | 1 2 3 4 5 6 |
| Valuing Diversity Behaviors | |
| Ensures that department activities are inclusive by verifying scheduling needs | 1 2 3 4 5 6 |
| Seeks input/feedback from diverse individuals and groups, including internal and external customers | 1 2 3 4 5 6 |
| Treats everyone with respect and fairness | 1 2 3 4 5 6 |
| Leadership Behaviors | |
| Encourages and embraces change by challenging the status quo |
1 2 3 4 5 6
|
| Provides cross-functional development opportunities for team members | 1 2 3 4 5 6 |
| Encourages and supports my involvement in training and development activities and events | 1 2 3 4 5 6 |
| Encourages and supports my involvement in community activities and events | 1 2 3 4 5 6 |
| Encourages and supports my involvement in company activities and events | 1 2 3 4 5 6 |
| Uses actions and behaviors that are consistent with his or her words | 1 2 3 4 5 6 |
| Is trustworthy | 1 2 3 4 5 6 |
| Is a role model for continuous improvement | 1 2 3 4 5 6 |
| Uses a coaching management style, rather than an authoritarian boss management style | 1 2 3 4 5 6 |
| Supports me and helps me achieve results | 1 2 3 4 5 6 |
| Supports a customer service approach for both internal and external customers | 1 2 3 4 5 6 |
| Deals with issues that need to be addressed | 1 2 3 4 5 6 |
Provides a clear sense of purpose and direction, roles and responsibilities, for me individually and for our group team members | 1 2 3 4 5 6 |
General Feedback
Optional: Type or print your answers; add additional pages if needed. Please be as specific as possible by including examples.
1. What activities, behavior, feedback or coaching would you like your manager to stop doing? Please explain.
2. List and briefly describe examples of the behavior, activities, feedback or coaching your manager has provided that makes your job and work environment more enjoyable and meaningful to you.
3. Please provide comments that you feel will be meaningful for your manager to sustain or improve his or her effectiveness.
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