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Leaders Listen to Learn Employee Feedback Form

Site*

Department*

Date*

Conversation Length

Supervisor Name*

Employee Name*

Employee ID*

Employee Type*

Conversation Duration*

Less than 30 minutes 30–45 minutes 46–60 minutes More than 60 minutes

1. Did you feel the supervisor listened
to you? *

Yes Somewhat No

2. Did you feel comfortable and respected during the conversation?*

Yes Somewhat No

3. Did the conversation help you get to know your supervisor better?*

Yes Somewhat No

4. What did you like most about
the conversation? Maximum 240 characters.

5. What could improve future Listen to Learn conversations? Maximum 240 characters.

6. Is there anything you would like leadership to know? Maximum 240 characters.

Overall experience:*

Excellent Good Fair Poor

Would you recommend continuing these conversations?*

Yes No

Important: This feedback is intended to improve the Listen to Learn experience. It should not be used for attendance, discipline, or performance evaluation. Capture broader themes without connecting individual names to concerns or proposed solutions.