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Please identify the corporate staff member about whom you are giving the feedback?
 
 
 
Communication with this corporate staff member is: (choose as many as you want or add your own in other)
 
Precise
 
Timely
 
Easy to understand
 
Imprecise
 
Untimely
 
Difficult to understand
 
Other
 

 
 
 
Communication with this person makes me feel:
 
Valuable
 
Respected
 
Motivated
 
Not valued
 
Disrespected
 
Not motivated
 
Other
 

 
 
 
This corporate staff member helps me be more productive:
 
All the time
 
Some of the time
 
Seldom
 
Never
 
Other
 

 
 
 
I feel this corporate staff member cares about me as a person:
 
Yes
 
No
 
Other
 

 
 
 
I see this corporate staff member as:
 
Trustworthy
 
A Leader
 
A Team Player
 
Untrustworthy
 
Lacks Leadership qualities
 
Cares more about him/her self than others or the company
 
Other
 

 
 
 
I have confidence in this persons abilities:
 
Yes
 
No
 
Other
 
 
 
 
I feel the conference calls are: 
 
Important
 
Unimportant
 
Informative
 
Uninformative
 
Helpful
 
Not Helpful
 
Other
 

 
 
 
When this person speaks on a conference call:
 
I feel comfortable to interact
 
I don't feel comfortable to interact
 
I feel my responses are valued
 
I feel my responses are ignored
 
I feel uplifted
 
I feel degraded
 
Other
 

 
 
 
When I have to contact this person for answers:
 
I don't hesitate to contact
 
I hesitate to contact
 
I feel confident in this person's answer/response
 
I don't feel confident in this person's answer/response
 
I never feel like an interruption
 
I feel like an interruption
 
Other
 

 
This survey is completely anonymous.  Your identity will not be revealed to any Beltone employee.  Please respond honestly and throughly.  This survey is intended to help improve relations among all employees. Thank you for your cooperation. 
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