EMPLOYEE FEEDBACK TEMPLATE

This template will be your instrument in providing performance evaluations to the employees. As
their immediate head, it is your responsibility to monitor their performance if they are eligible for
regularization or promotion. The HR department will then assess it. Securing yourself a decent
employee feedback form is essential to make sure that all the areas of performance are covered.

[INSERT COMPANY LOGO]

[INSERT COMPANY NAME]

EMPLOYEE NAME: [INSERT EMPLOYEE’S NAME]

EMPLOYEE ID NO.: [INSERT ID NO.]
DEPARTMENT: [INSERT DEPARTMENT]
DATE EVALUATED: [INSERT DATE]

*Rate the employee by putting a check (✔) mark under the corresponding scale below.

EVALUATION ITEM Always Often Sometimes Rarely Never

SCOPE OF WORK
1. Demonstrates familiarity with the
line of work.

2. Works without supervision.

3. Strives for efficiency at all times.

4. Is professional towards colleagues

and immediate heads.

5. Shows reliability when assigned a

task.

6. Makes sound judgment.

ATTENDANCE
1. Attends work on time.

2. Makes use of leave forms, under

time and overtime forms
appropriately.

3. Informs immediate head regarding

emergencies that need to be attended.

PEER RELATIONSHIP
1. Works well with a group.
2. Helps resolve conflicts.

3. Communicates effectively with

colleagues and immediate heads.

[INSERT ADDITIONAL
EVALUATION ITEM]

1. What are the employee’s strengths?

2. What are the different areas that the employee needs to work on?

3. Additional comments:

EVALUATED BY: APPROVED BY:

___________________________ ___________________________
IMMEDIATE HEAD/SUPERVISOR HR MANAGER