Wellbeing Conversations - Record of discussion

1. Colleague Name: *

2. Job Title: *

3. Staff Group: *

4. Division *

5. Date wellbeing conversation took place:

	DD/MM/YYYY

6. Was the wellbeing conversation carried out by your line manager? *

Yes
No

If no, please specifiy reason

7. On a scale of 0-5, with 0 being poor and 5 being excellent:

Please rate your experience of your wellbeing conversation.

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