Communication - 360 Degree Feedback Survey Sample #4

Dear Employee:

Welcome to our 360-Degree Feedback self-assessment questionnaire. Our objective is to provide feedback which will help advance your leadership skills and capabilities. We are asking you to take time to respond to this survey to help us identify areas where you are doing well and where you have opportunities to do better. Others will also complete the questionnaire to provide you with feedback.

We have developed this survey with questions tailored for your position in the department to provide you with an opportunity to rate many facets of your leadership performance.

Please be honest, constructive and thoughtful in your responses. The results of this survey will be used to help drive our future success. If you have any questions about the process please contact [Contact Person].

Please ensure that your submission is made between . The survey will only be available during these dates.

Thank you for your participation in the survey. We look forward to seeing the analysis of your responses and we are hoping for 100% participation.

Management Team



Instructions:
Please complete the items below and press the submit button at the end of the survey. If you need multiple sessions to complete the survey, please click the "Submit" button at the end of each session to save your responses. Please feel free to skip any items that you do not wish to respond to. Keep in mind that your responses help us to become a better place to work. So, you are encouraged to respond to all items on the questionnaire.

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Communication Skills	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You choose the communication medium (ie. email, voice mail, memo, project document) that reflects the needs of the content. (ie. urgency, confidentiality, content scope)
You present information in a clear and logical format.
I am open to receiving feedback from others.
You overcome barriers that prevent effective communication.
I use polite language and show respect for others' opinions and time.
Adaptability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You promote a culture of adaptability and flexibility.
You are able to adjust plans to meet new situations.
You make adjustments as need to meet the demands of a dynamic marketplace.
You are aware of changes to team personnel.
I am able to meet the needs of various stakeholders.
Cultural Awareness	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
I am aware of differences in how individuals from other cultures greet one another.
I am aware of my cultural views.
You uphold inclusive policies that protect cultural expression and identity in the workplace.
I facilitate team-building activities that celebrate diversity and foster mutual respect.
I view diversity as a strength, not as an issue.
Leadership	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You demand attention to detail and precision in all work.
You gain commitment by persuasion.
I demonstrate bravery in addressing challenging matters directly and effectively.
You mentor others.
You remain open to suggestions, ideas, and opinions of others.
Delegation	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You seek acceptance of the delegated task from the employee.
I choose the most qualified employee for the assignment.
You distribute the workload evenly to the team members.
You assign challenging responsibilities to boost employee professional development while maintaining engagement.
You hold employees accountable for assigned tasks.
Innovation	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You offer solutions to problems when talking with clients.
I am willing to entertain and experiment with new ideas leading to potential breakthrough innovations and competitive advantages.
You offer innovative solutions to Company problems.
You suggest new ideas at meetings.
I customize novel ideas to better address customer needs and preferences.
Results Oriented	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You track individual and team contributions against goals and communicate outcomes transparently.
I model accountability by owning mistakes and demonstrating corrective action.
You encourage self-assessment and reflection to build personal responsibility for results.
I clearly define roles and expectations.
You concentrate efforts on the most urgent needs.
Safety	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You develop safety guidelines for the department.
You participate in safety training as applicable.
You keep accurate safety records.
You develop a strong safety culture.
You identify and addresses safety needs.
Responsible	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You are a person others can trust.
You set high personal standards of performance.
You set a good example
Your behavior is ethical and honest.
You hold yourself accountable to goals / objectives
Regulatory/Compliance	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
I develop regulatory compliance strategies.
I tain and coordinate activies of compliance officers.
I develop the appropriate incentives (or disincentives) for regulatory compliance.
I periodically assess the effectiveness of regulatory/compliance programs.
I perform annual/monthly compliance audits.

51. On a scale of Excellent to Poor, how would you rate your overall employment with [Company] and why?
    

    -Excellent -Good -Average -Poor




52. Would you refer others who are seeking employment to [Company]?
    Yes No
    
    Please provide explanation:
    
    
    
53. If you had an opportunity to make any change you wanted to make [Company] a better place to work, what one improvement would you make?
    
    
    
54. What changes do you see [Company] making in order to raise the standards?
    
    
    
55. I feel good about my continued employment with [Company].
    Yes No
    
    If no, please provide explanation:
    
    
    
56. What do you like best about working for [Company]?
    
    
    
57. What do you like least about working for [Company]? How could it be improved?
    
    
    
93. Use the space below to enter any final comments you would like to be noted: