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Feedback - 360 Degree Feedback Survey Sample #2





Questionnaires Measuring Feedback:
Survey 1 (4-point scale; Competency Comments)
Survey 2 (4-point scale; Competency Comments)
Survey 3 (5-point scale; Competency Comments)
Survey 4 (5-point scale; radio buttons)
Survey 5 (4-point scale; words)
Survey 6 (4-point scale; words)
Survey 7 (5-point scale; competency comments; N/A)
Survey 8 (3-point scale; Agree/Disagree words; N/A)
Survey 9 (3-point scale; Strength/Development; N/A)
Survey 10 (Comment boxes only)
Survey 11 (Single rating per competency)
Survey 12 (Slide-bar scale)
Survey 13 (4-point scale; numbers; floating anchors)
Survey 14 (4-point scale; N/A)
Instructions

You have been selected to provide feedback on the employee listed above. Your feedback is an important part of our company's leadership development process and this survey is intended to gather broad feedback in the core competencies and role responsibilities that are important for the on-going success of our organization.

In responding to the questions below, think about your experiences working with this employee over the last twelve months and the goals they were asked to achieve. The effectiveness of this development tool is dependent on your honest, forthright and constructive responses so please bear this in mind as you answer each question. Your responses will be discussed with the employee to foster growth and on-going development.

Competencies Included:
Feedback, Leadership, Persuasion and Influence, Creativity, Self Management, Passion To Learn, Delegation, Clarity, Company, Fiscal Management
Sample Result Document:
Sample Results
Partially completed forms can be saved by using the Save/Still Working button at the bottom of the page. You may return at a later time to complete/edit the form. Your saved responses will be shown each time you re-visit the feedback form. When you are certain that you have completed your responses and will be not making any changes, click the Complete button.

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

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Implements concrete solutions to address issues identified via feedback.
  1. Actively seeks feedback from others.
  1. Addresses specific actions or behaviors, rather than making it about the person's character.
  1. Involves external stakeholders, such as customers, partners, and industry experts, to bring in fresh perspectives and innovative ideas.
  1. Addresses specific issues and provides constructive advice, feedback, and helps individuals improve their performance.
What are your suggestions for how [Participant Name] can make improvements
in Feedback?

Leadership

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Performs effectively, even under frustrating or challenging work conditions
  1. Acts decisively in implementing decisions.
  1. Inspires a sense of pride and shared ownership.
  1. Responds to performance feedback, identifying development opportunities (i.e., training) related to current job
  1. Actively seeks input from employees and incorporates their ideas into decision-making.
What are your suggestions for how [Participant Name] can make improvements
in Leadership?

Persuasion and Influence

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Gains participation by others to accomplish goals.
  1. Obtains the support of others to accomplish goals.
  1. Creates a compelling message that is persuasive.
  1. Works to persuade others.
  1. Frames proposals in terms of shared benefits, linking outcomes to what matters most to the audience.
What are your suggestions for how [Participant Name] can make improvements
in Persuasion and Influence?

Creativity

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Introduces creative practices that elevate team collaboration and morale.
  1. Creates a lot of new ideas.
  1. Develops imaginative approaches that better serve stakeholder needs.
  1. Is open to creative ideas.
  1. Regularly asks probing questions to uncover deeper possibilities.
What are your suggestions for how [Participant Name] can make improvements
in Creativity?

Self Management

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Sets an example for associates during stressful periods by maintaining a positive, can-do attitude.
  1. Analyzes interpersonal problems instead of reacting to them.
  1. Uses patience and self-control in working with customers and associates.
  1. Analyzes own reactions on the spot to ensure that communication does not appear to be driven by anger.
  1. Steps away from a situation to process appropriate response.
What are your suggestions for how [Participant Name] can make improvements
in Self Management?

Passion To Learn

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Enjoys learning new skills and techniques.
  1. Takes initiative for own learning and development.
  1. Holds self and associates accountable for goal achievement.
  1. Embraces new technology and procedures.
  1. Will participate in training classes even if offered outside of normal working hours.
What are your suggestions for how [Participant Name] can make improvements
in Passion To Learn?

Delegation

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Keeps employees informed of any changes to plans.
  1. Avoids an arbitrary delegation of duties, which can lead to inefficiencies or frustration.
  1. Encourages the employee to take ownership of the responsibility.
  1. Ensures delegated tasks are completed on time.
  1. Holds employees accountable for assigned tasks.
What are your suggestions for how [Participant Name] can make improvements
in Delegation?

Clarity

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Clearly defines work objectives for employees.
  1. Makes sure employees understand why they were given certain assignments.
  1. Checks details thoroughly.
  1. Avoids stating unclear or conflicting goals.
  1. Clarifies problems and their causes to help employees correct them.
What are your suggestions for how [Participant Name] can make improvements
in Clarity?

Company

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Defines clear roles and responsibilities to reduce friction and enhance coordination
  1. Creates reasonable and timely policies regarding social media.
  1. Paints a compelling picture of the company's future and inspires others to work toward it.
  1. Works effectively across different departments at the company.
  1. Encourages open dialogue and mutual support among team members.
What are your suggestions for how [Participant Name] can make improvements
in Company?

Fiscal Management

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Provides budgeting and accounting support to the Company.
  1. Keeps excellent records for financial transparency.
  1. Develops budgets and plans for various programs and initiatives.
  1. Develops of the department's annual budget.
  1. Monitors expenses and verifies the need for items purchased.
What are your suggestions for how [Participant Name] can make improvements
in Fiscal Management?


  1. Strengths


  2. Areas for Development


  3. Please give any final comments or suggestions for [Participant Name Here]'s assessment.