Attitude - 360 Degree Feedback Survey Sample #8

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.

Respond to the assessment form based on your work experiences during the previous 12 months. Your responses will be merged with other people's feedback and presented to you in your on-going development. Comments from others will be shared anonymously, as written.

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 .

Attitude	Agree	Unsure	Disagree	N/A
You treat all people fairly and with respect.
You contribute to a positive and fun work environment.
You work to eliminate unnecessary work or barriers that get in others' way.
You build open and trusting relationships.
You visibly support and encourages diversity in style and background.
Flexibility	Agree	Unsure	Disagree	N/A
I innovate skills and modify behaviors to remain flexible in addressing important issues.
You incorporate new skills fluently.
You are open to adapting thoughts, behaviors, and strategies in response to evolving situations and new information.
You are dedicated to evolving and enhancing business processes, which demonstrates flexibility.
You act decisively in frequently changing and uncertain environment.
Continual Learning	Agree	Unsure	Disagree	N/A
You grasp new ideas, concepts, technical, or business knowledge.
You take charge of your training and skills enhancement.
You improve on your skill sets.
You share best practices with others and learn from others.
I view setbacks as opportunities to learn from.
Establishing Focus/Direction	Agree	Unsure	Disagree	N/A
You help guide employees with prioritizing tasks.
You make sure that employees understand how their work relates to organizational goals.
You maintain self-control when personally criticized.
You function well under stress, deadlines, and/or significant workloads.
You align the department's goals with the goals of the organization.
Analytical	Agree	Unsure	Disagree	N/A
You identifiy opportunities for progress and innovation.
You select the appropriate techniques for analysis.
You ask the "right" questions to size up or evaluate situations.
You implement data validation techniques and methods.
You balance risks and costs with the reward and probabilities of success when decisions.
Initiative	Agree	Unsure	Disagree	N/A
You immediately inform the HR Department of any personnel complaints or issues.
You act on own initiative to improve the department outcomes.
I seize upon chances to improve the department's prospects.
I am able to initiate work on projects independently without direct supervision.
I take charge when there is a crisis.
Results Oriented	Agree	Unsure	Disagree	N/A
You strive to achieve high volume of output.
I am motivated by a strong desire to exceed performance standards.
You create measures of performance to track progress.
You determine the parts of the project that need completed first.
You make changes to the plans if it will result in increased output.
Objectives	Agree	Unsure	Disagree	N/A
You assure [Company] principles are understood, employed & pursued.
You are able to organize work.
You are able to establish realistic goals.
You organize and schedules events, activities, and resources.
You set long-term and short-term goals.
Interpersonal Skills	Agree	Unsure	Disagree	N/A
You are open and approachable
You understand the core issues of conversations.
You strive for win/win solutions
You express appreciation of other's work.
I am transparent and honest in communications, intentions, and actions.
Client Focus	Agree	Unsure	Disagree	N/A
I am competent in handling client cases.
You deliver on commitments made to clients.
I make sure team members understand the issues faced by the client.
I tailor innovative products for each client.
I understand what resources are needed to meet client needs.
Co-worker Development	Agree	Unsure	Disagree	N/A
You set and clearly communicate expectations, performance goals, and measurements to others
You work to identify root causes of performance problems
You give others development opportunities through project assignments and increased job responsibilities
You provide ongoing feedback to co-workers on your development progress
You adapt coaching and mentoring approach to meet the style or needs of individuals

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

    5- Very Effective 4- Effective 3- Neither 2- Ineffective 1- Very Ineffective

    
    
57. Strengths
    
    
    
58. Areas for Development
    
    
    
59. Please give any final comments or suggestions for [Participant Name Here]'s assessment.