Attitude - 360 Degree Feedback Survey Sample #2





Questionnaires Measuring Attitude:
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)
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:
Attitude, Leadership, Communication Skills, Administrative Skill, Initiative, Change Management, Clarity, Customer Focus, Others, Entrepreneurship, Global Perspective
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.


Attitude

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Contributes to a positive work environment.
  1. Builds open and trusting relationships.
  1. Shows by their actions that they trust in the positive intentions of others.
  1. Is gracious and professional in their interactions with others.
  1. Visibly supports and encourages diversity in style and background.
What are your suggestions for how [Participant Name] can make improvements
in Attitude?

Leadership

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Takes ownership and accountability for results
  1. Leads team to set goals, solve problems, and accomplish tasks.
  1. Highly effective supervisor.
  1. Holds others accountable for their actions.
  1. Gives direct, constructive, and actionable feedback.
What are your suggestions for how [Participant Name] can make improvements
in Leadership?

Communication Skills

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Deals with difficult situations calmly and confidently.
  1. Conveys ideas confidently and succinctly.
  1. An effective listener who is responsive to information needs.
  1. Addresses issues of key importance to stakeholders.
  1. Able to demonstrate persuasiveness in pursuit of objectives.
What are your suggestions for how [Participant Name] can make improvements
in Communication Skills?

Administrative Skill

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Strong organizational skills to keep the workspace and department in order
  1. Able to develop, justify and present a budget.
  1. Implements and uses performance measures.
  1. Completes reports on-time.
  1. Accurately implements contract provisions.
What are your suggestions for how [Participant Name] can make improvements
in Administrative Skill?

Initiative

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Takes the initiative to complete tasks ahead of schedule.
  1. Confronts problems immediately without supervisor instructions.
  1. Quickly comes to the aid of those who may need help.
  1. Independently seeks out new learning opportunities to improve their skills.
  1. Takes action to establish clear and concise deadlines for tasks to be completed.
What are your suggestions for how [Participant Name] can make improvements
in Initiative?

Change Management

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Effective in implementing new organizational vision and values.
  1. Facilitates change with minimal resistance.
  1. Adopts changes to set and example for others to follow.
  1. Effective in dealing with ambiguous and challenging situations.
  1. Works cooperatively with others to implement changes.
What are your suggestions for how [Participant Name] can make improvements
in Change Management?

Clarity

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Uses appropriate grammar and tense in communications.
  1. Makes sure goals and objectives are clearly and thoroughly explained and understood.
  1. Avoids creating ambiguity or mixed messages.
  1. Communicates with clarity and efficiency.
  1. Seeks to reduce ambiguity in messaging and documents.
What are your suggestions for how [Participant Name] can make improvements
in Clarity?

Customer Focus

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Anticipates and proactively resolves issues that the customer may face.
  1. Fulfills commitments made to customers.
  1. Meets with customers on a regular basis.
  1. Prioritizes customer issues based on urgency.
  1. Acts with integrity in all customer interactions.
What are your suggestions for how [Participant Name] can make improvements
in Customer Focus?

Others

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Includes others in the decision making processes.
  1. Forms working relationships with employees from other departments.
  1. Supports the efforts of other employees in implementing solutions to problems.
  1. Treats others with respect and dignity.
  1. Constructively receives criticism and suggestions from others.
What are your suggestions for how [Participant Name] can make improvements
in Others?

Entrepreneurship

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Excellent at managing relationships with stakeholders.
  1. Finds unique ways to go around barriers to success.
  1. Understands the processes and various stages of business development.
  1. Able to adapt the department to changing business demands and climate.
  1. Balances risks and rewards when making decisions.
What are your suggestions for how [Participant Name] can make improvements
in Entrepreneurship?

Global Perspective

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Is able to work with individuals having different backgrounds and cultures.
  1. Cooperates with others on a global scale.
  1. Comfortable using teleconferencing equipment to facilitate meetings with others abroad.
  1. Communicates effectively on a multi-lingual basis.
  1. Builds working relationships with others across cultures.
What are your suggestions for how [Participant Name] can make improvements
in Global Perspective?


  1. Strengths


  2. Areas for Development


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