1.Employee name and title?

Director, Renee MichelAdministrative Assistant II, Angela MoreiraFire Safety/ Prevention Safety Specialist I, Diana KerrisonFire Safety/ Prevention Safety Specialist I, Liangely Guilbe-PerezWorkplace Safety Officer, Jacob JacksonRadiation Safety Officer, Mario De VeraBiosafety Specialist, Dan FryBiosafety Officer, Melina KinseyChemical Safety and Security Senior Coordinator, Sandra HickEnvironmental Technician, Aaron YoungEHS Health Science Campus Coordinator, Thaismary MoralesLaboratory Safety Specialist,  Franco Del PinoOther (please specify)

2.Are you one of the following?

StudentCollegueFacultyVendorSupervisorGovernment Agency OfficialStaffVisitorOther

3.On a scale from 1 (not at all relevant) to 5 (extremely relevant), please rate how relevant each statement is to your experience with this employee.

1- Not at all relevant

2

3

4

5-Extremely Relevant

I felt that this employee was helpful.

1- Not at all relevant

2

3

4

5-Extremely Relevant

I felt that this employee was respectful.

1- Not at all relevant

2

3

4

5-Extremely Relevant

This employee had a pleasant attitude.

1- Not at all relevant

2

3

4

5-Extremely Relevant

I would call this employee a problem solver.

1- Not at all relevant

2

3

4

5-Extremely Relevant

I felt that this employee has good time management skills.

1- Not at all relevant

2

3

4

5-Extremely Relevant

This employee had a good responsiveness and got to my problem in a timely manner.

1- Not at all relevant

2

3

4

5-Extremely Relevant

4.Please list any areas where this employee is doing particularly well.

5.Please list any areas for improvement for this employee.

6.Please give your overall rating of this employees work on a scale from 1 (low) to 5 (high).

1

2

3

4

5

1

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5