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Attitude - 360 Degree Feedback Survey Sample #3





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)
Survey 13 (4-point scale; numbers; floating anchors)
Survey 14 (4-point scale; N/A)
Instructions

You have been asked to evaluate yourself as part of a 360-degree feedback process. Other employees, including your manager(s), peers, and direct reports will also evaluate you. In this manner, you will be provided with a comprehensive, multi-perspective (i.e., 360-degree) view of your performance as a manager. The objective is to provide you with feedback so as to allow you to improve your performance, resulting in improved team performance, and organizational effectiveness.

If you are not able to respond to an item, leave it blank and go on to the next item.

Competencies Included:
Attitude, Flexibility, Creativity, Delegation, Time Management, Objectives, Interpersonal Skills, Client Focus, Developing Others
Sample Result Document:
Sample Results
We encourage everyone to complete the survey. Please be honest, constructive and thoughtful in your input. The survey is designed to help us understand more about your thoughts and needs to make this a great company.

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



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Attitude

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Expresses sincere appreciation for others' efforts -- regardless of how routine or behind-the-scenes they may be.
  1. Offers to lead new initiatives, pilot programs, or improvement efforts to advance team goals.
  1. Expresses belief in the team's ability to overcome obstacles and deliver results.
  1. Accommodates differing work styles and needs when planning team interactions.
  1. Highlights progress and effort, even if outcomes are still emerging.
Please feel free to provide any comments to help explain your answers?

Flexibility

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
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Competency
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Exhibits this
Competency
  1. Implements changes as a result of having listened to employees
  1. Experiments with new ideas to create innovative solutions to issues.
  1. Innovates skills and modifies behaviors to remain flexible in addressing important issues.
  1. Adapts easily to incorporate various perspectives.
  1. Adapts workflows according to changing needs.
Please feel free to provide any comments to help explain your answers?

Creativity

Does Not
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Competency
Seldom
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Competency
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Exhibits this
Competency
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Competency
  1. Creates opportunities for self-directed creative inquiry.
  1. Synthesizes learned information into innovative designs.
  1. Facilitates creative exchange across organizational boundaries.
  1. Considers problems from multiple angles to uncover new approaches.
  1. Finds creative ways to meet the needs of patients.
Please feel free to provide any comments to help explain your answers?

Delegation

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
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Competency
Always
Exhibits this
Competency
  1. Assigns tasks to help build the skill sets of subordinates.
  1. Ensures delegated tasks are completed on time.
  1. Matches employees' competencies with projects that maximize their potential.
  1. Entrusts employees with tasks that reflect their core proficiencies, fostering accountability and confidence.
  1. Is flexible and adjusts delegation strategies based on results and employee response.
Please feel free to provide any comments to help explain your answers?

Time Management

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
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Competency
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Competency
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Competency
  1. Manages work time and family life to bring both into balance.
  1. Tackles major issues head on to reduce the amount of time spent on them.
  1. Works quickly to keep on schedule.
  1. Delegates administrative and support functions to optimize time for strategic planning and leadership.
  1. Outperforms others in productivity through effective time management.
Please feel free to provide any comments to help explain your answers?

Objectives

Does Not
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Competency
Seldom
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Competency
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Competency
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Exhibits this
Competency
  1. Works toward achieving established goals and objectives.
  1. Assures [Company] principles are understood, employed & pursued.
  1. Communicates goals and objectives to employees.
  1. Able to organize work.
  1. Encourages me to take on greater responsibility.
Please feel free to provide any comments to help explain your answers?

Interpersonal Skills

Does Not
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Competency
Seldom
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Competency
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Competency
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Competency
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Exhibits this
Competency
  1. Attends to both the content and the context of what was being said.
  1. Values the opinions of others.
  1. Comes across as credible, knowledgeable and sincere
  1. Adapts management style to meet the needs of the individual or situation.
  1. Is willing to lend a hand to those in the department who need help.
Please feel free to provide any comments to help explain your answers?

Client Focus

Does Not
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Competency
Seldom
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Competency
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Competency
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Competency
  1. Satisfies client needs.
  1. Delivers high quality products to the client.
  1. Engages with clients on multiple levels.
  1. Able to handle difficult clients.
  1. Ensures commitments made to clients are completed to the client's satisfaction.
Please feel free to provide any comments to help explain your answers?

Developing Others

Does Not
Exhibit this
Competency
Seldom
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Competency
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Exhibits this
Competency
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Exhibits this
Competency
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Exhibits this
Competency
  1. Sets performance objectives for subordinates that encourages development opportunities.
  1. Is open to receiving feedback.
  1. Develops employees by offering and encouraging them to take on new or additional responsibilities.
  1. Tries to ensure employees are ready to move to the next level.
  1. Assesses employees' developmental needs.
Please feel free to provide any comments to help explain your answers?

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






  2. Strengths


  3. Areas for Development


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