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Run: Skip Level Meeting Form

A skip level meeting form for capturing wins, blockers, support needed, and feedback for a direct manager before the conversation. It helps employees prepare...

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Meeting Context

Meeting date (required)

Select the date of your skip-level meeting.

Primary topic for this meeting (required)

Choose the main focus area for the discussion.

If other, describe the topic

Briefly describe the topic if it is not listed above.

Recent Wins

What have been your recent wins? (required)

Summarize 1-3 specific accomplishments, improvements, or positive outcomes.

What impact did these wins have?

Describe the business, team, customer, or process impact if relevant.

Who or what helped make these wins possible?

Select any contributors or support sources that should be recognized.

Challenges and Blockers

What challenges or blockers are you facing? (required)

Describe the main issues affecting your work, team, or goals.

Which area best describes the challenge?

Select one or more categories that apply.

How urgent is this issue?

Rate the urgency of the issue from low to high.

Support Needed

What support do you need? (required)

Select all forms of support that would be helpful.

Describe the support you need

Provide specific context, examples, or the decision you are seeking.

Who can best help with this?

Choose the person or group most likely to help.

Feedback for Direct Manager

What feedback do you have for your direct manager?

Be specific and work-related. Focus on behaviors, support, communication, or decision-making.

What area does this feedback relate to?

Select the areas that best match your feedback.

Would you like follow-up on this feedback? (required)

Choose yes if you want this feedback discussed further after the meeting.

Additional Notes

Anything else you'd like to discuss?

Use this space for other questions, ideas, or topics.

Preferred follow-up method

Choose how you'd like to receive follow-up if needed.

Get your results

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Email (required)

Your name (optional)

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