[Company Logo][Company Name]
- Company:
- [Company Name]
- Manager Being Evaluated:
- [Reporting Manager]
- Department:
- [Department]
- Survey Closes:
- [DD/MM/YYYY]
This form is anonymous. Do not write your name. Responses are collected by HR, combined with others and shared with your manager only as overall themes. Please answer honestly and respectfully, based on your own experience.
Agreement Scale
| Score | Meaning |
|---|
| 5 | Strongly agree |
| 4 | Agree |
| 3 | Neither agree nor disagree |
| 2 | Disagree |
| 1 | Strongly disagree |
Section 1: Direction and Communication
| Statement | Score (1–5) |
|---|
| My manager sets clear goals and priorities for me | [Score] |
| My manager keeps the team informed about changes | [Score] |
| My manager is available when I need guidance | [Score] |
Section 2: Fairness and Respect
| Statement | Score (1–5) |
|---|
| My manager treats all team members fairly | [Score] |
| My manager gives credit for good work | [Score] |
| I feel safe raising concerns with my manager | [Score] |
| My manager handles workload and leave requests fairly | [Score] |
Section 3: Growth and Feedback
| Statement | Score (1–5) |
|---|
| My manager gives me useful, regular feedback | [Score] |
| My manager supports my learning and career growth | [Score] |
| My appraisal discussions are honest and well-prepared | [Score] |
Section 4: Open Comments
| One thing my manager should start doing | [Comment] |
|---|
| One thing my manager should keep doing | [Comment] |
|---|
| Any other feedback | [Comment] |
|---|
For HR use only: Responses received [Number] | Average score [Score] | Summary shared on [DD/MM/YYYY] by [HR Name].