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"Boss" Evaluation Form

courtesy of Heartwood Veterinary Clinic

This form may be used to evaluate a supervisor, team leader, employer, manager, etc.

Please help me by completing this anonymous appraisal so that I can become a better "boss".
How to Evaluate:
AAHA suggests that it is a good idea to ask the hospital staff for an "upward appraisal" of the boss at
least once a year. I'd like to get your feedback. Please complete this form, place it in a SEALED
envelope, and put it in __________'s box (managers, owners, whomever will be tallying the
results, NOT the person being reviewed). This person will then tally the results and create an average
for each question. Any written comments will be typed up separately and added to the tallies. In order
to complete the anonymity of this form, please DO NOT sign it or put your name on it.

Name of person to be reviewed: ___________________________

 
No Opinion
Poor
Fair
Good
Excellent
 
0
points
1
point
2 points
3 points
4
points
1. Conducts him/herself in a professional manner.          
2. Is a good listener          
3. Is good at giving feedback to others          
4. Is open to other people's ideas and opinions          
5. Is thoughtful and considerate of staff members          
6. Has good self-control under pressure          
7. Will admit it or apologize when wrong          
8. Is punctual          
9. Leaves personal affairs at home          
10. Gives compliments and positive feedback          
11. Provides on-the-job training          
12. Willingly answers questions from staff members          
13. Lets me know in a fair and constructive manner when I have done something wrong          
14. Keeps his/her promises          
15. Delegates the authority I need to do my job          
16. Has good people skills          

17. What one change or one thing can I (the reviewee) do to better support you (the staff member)?

 

18. Any Additional Feedback (positive or negative) is appreciated!

 


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