INSTRUCTIONS: This electronic survey is part of the manager's evaluation and is confidential. This means your name will NOT be
used in any way to identify who made comments or provided ratings. The information you provide will be used only in summary
as evidence to document the manager's current performance and areas for improvement. You can submit this form electronically or in
print.
In addition to the checked responses below, please feel free to make comments. The evaluatee's job description should be attached to
the email with this survey. *Note: if "Below Expectations" is marked for an item, please elaborate. Negative unsubstantiated comments
not related to pertinent job duties will not be placed into the Leadership Team Member's personnel file.
1. Job Function: Please describe the nature of your interaction with this Leadership Team Member and rate
the effectiveness of your interactions.
Exceeds expectations Meets expectations Below expectations*
2. Comments on Job Function:
3. Leadership: Please rate this Leadership Team Member's effectiveness as a leader.
Exceeds expectations Meets expectations Below expectations*
4. Comments on Leadership:
5. Communication: Please rate this Leadership Team Member's written and verbal communication skills in
matters related to your program's/department's needs.
Exceeds expectations Meets expectations Below expectations*
6. Comments on Communication:
