| Instructions:
This questionnaire contains items that ask you to describe your relationship with either your leader or one of your followers. For each of the items, indicate the degree to which you think the item is true for you by selecting one of the responses that appear below the item. 1- Rarely, 2-Occasionally, 3-Sometimes , 4-Fairly often, 5-Very often |
| Statements | | | | | | Observer 1 | Observer 2 | Observer 3 | Observer 4 | Average | Self Asssessment |
| Do you know where you stand with your leader (follower) . . . [and] do you usually know how satisfied your leader (follower) is with what you do? | | | | | | 4 | 4 | 4 | 4 | 4 | 4 |
| How well does your leader (follower) understand your job problems and needs | | | | | | 4 | 5 | 4 | 4 | 4.25 | 4 |
| How well does your leader (follower) recognize your potential? | | | | | | 4 | 4 | 5 | 3 | 4 | 4 |
| Regardless of how much formal authority your leader (follower) has built into his or her position, what are the chances that your leader (follower) would use his or her power to help you solve problems in your work? | | | | | | 5 | 5 | 5 | 4 | 4.75 | 5 |
| Again, regardless of the amount of formal authority your leader (follower) has, what are the chances that he or she would “bail you out” at his or her expense? | | | | | | 4 | 3 | 2 | 5 | 3.5 | 3 |
| I have enough confidence in my leader (follower) that I would defend and justify his or her decision if he or she were not present to do so | | | | | | 4 | 3 | 5 | 3 | 3.75 | 4 |
| How would you characterize your working relationship with your leader (follower)? | | | | | | 5 | 4 | 3 | 5 | 4.25 | 4 |