Accountability - 360 Degree Feedback Survey Sample #8

Questionnaires Measuring Accountability:
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)
Self-Assessment Instructions

You have been selected to complete a self-assessment questionnaire as part of a 360-degree feedback assessment. Your feedback is an important part of 's leadership development process. This tool is intended to gather broad feedback in the core competencies and role responsibilities that are important for the on-going success of our organization.

Sample Result Document:
Sample Results
Method of use: As part of the review process, managers will receive feedback from peers and staff. It is recognized that not all participants will be able to assess an individual's performance in all areas. The feedback received will be utilized as input to the manager's performance and on-going development plan.

You may sign out at any time by pressing the Save button at the end of the form and then closing your browser. You may return later to pick up where you left off. When you are done, press the Complete button.

Please complete your response by .


Agree Unsure Disagree N/A
  1. You can be counted on to do what you say you are going to do.
  1. You take ownership of mistakes and learn from them.
  1. You create a consistent process for prioritizing work.
  1. You tackle issues head on and finds solutions.
  1. You are aware of problems or issues that may affect the organization.

Administrative Skill

Agree Unsure Disagree N/A
  1. You are enthusiastic about taking on challenging projects.
  1. You accurately implement contract provisions.
  1. You are able to develop, justify and present a budget.
  1. You have a high attention to detail.
  1. You have strong organizational skills to keep the workspace and department in order

Change Management

Agree Unsure Disagree N/A
  1. You address organizational and departmental resistance to changes.
  1. You adopt changes to set and example for others to follow.
  1. You support new initiatives for organizational changes to improve effectiveness.
  1. You are effective in dealing with ambiguous and challenging situations.
  1. You support the Company's efforts to implement changes.

Managing Risk

Agree Unsure Disagree N/A
  1. You are committed to implementing rules and procedures to minimize risk.
  1. You reward innovative experiments to try new ideas.
  1. You base decisions on patterns found in fluid/changing information.
  1. You work within constraints of the organization.
  1. You create a risk profile for projects and teams.


Agree Unsure Disagree N/A
  1. You are familiar with EEOC, FLSA, OSHA and ERISA acts/standards.
  1. You work quickly to implement changes in regulations.
  1. You keep track of changes in legislation affecting regulatory compliance.
  1. You comply with trade agreements affecting international companies.
  1. You perform audits regularly, or without notice, to ensure proper compliance with regulations.

Customer Focus

Agree Unsure Disagree N/A
  1. You ask questions and listen carefully to determine customer needs and to ensure that the customer's needs are met.
  1. You consistently model positive customer service attitudes.
  1. You ensure all customer commitments and requirements are met or exceeded.
  1. You maintain positive customer relationships.
  1. You develop good rapport and trust with the customer.

Organizational Fluency

Agree Unsure Disagree N/A
  1. You are able to deal with sensitive issues with tact and professionalism.
  1. You get things done through the department.
  1. You are aware of other organizational cultures to compare/contrast with the current organizational culture.
  1. You are able to use corporate politics to advance department objectives.
  1. You anticipate problems that may affect the department.


Agree Unsure Disagree N/A
  1. You work to support the strategy of [Company]
  1. You behave in a way that is consistent with business values & code of conduct
  1. You persuade others to follow the Company's vision.
  1. You lead employees in new directions.
  1. You expresse the Company vision in a way that is easily understood and adopted by employees.

  1. Overall, please rate the effectiveness of [Participant Name Here].

  2. Strengths

  3. Areas for Development

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