Employee Feedback Form

Date Submitted

Month Day Year
Hour Minutes AM/PM Option
Employee Feedback Form

While many people say communication is key, creating a method for communication to flow is often forgotten. The purpose of this form is for our employees to always have a way to bring suggestions, complaints, concerns, or questions to your management teams attention and then to have it documented so that our response is performed in a timely manner.
Name *

First Name Last Name
Feedback Type

Comments Suggestions Questions Complaint Other
How urgent of a matter do you believe this is? *

1

2

3

4

5

1 is Not Urgent , 5 is Extremely Urgent
Please leave a detailed comment/question/suggestion. *
Suggested solutions or resolution
Would you like a manager to contact you via the phone as soon as possible? *

Yes, any manager is fine No, just wanted to voice my thoughts Please have Ian contact me as soon as possible
Would you like this to be brought up during an employee meeting? *

Yes No
Would you like to be kept anonymous? *

Yes No
Would you like a copy of your submission emailed to you?

Yes No
Email

Confirmation Email example@example.com
Should be Empty: