UHC Receiving Feedback Assignment Encarnacion

Feedback Survey
(given to peers to fill out - required to be turned in with essay)

Think about the relationship you have with the person who gave you this survey. You will be
asked to answer each question honestly in regard to how you view them as an individual.

1. You deserve to be proud of your _____ , _____ and _____.

2. I wish you would tell me more about _____.

3. I wish you would talk less about _____.

4. I am uncomfortable or embarrassed when you _____.

5. When I am talking about something I’m interested in or concerned about, I don’t like it when

you _____.

6. I appreciate it when you _____.

7. I admire your ability to ______.

8. Your friends are lucky because you are usually _____, _____ and _____.

9. Your friends have to tolerate your tendency to _____, or _____.

10. The most positive change I’ve seen in you lately is _____.

11. One thing I think you could work to improve on is ______.

12. I am hesitant to come to you about _____ because I am afraid of how you will react.

13. Three difficult situations that I think you handled well are:

a.

b.

c.

14. In my opinion, you do (did) not handle situations well when_____ because______.

15. One area I’ve seen you grow in is ______.