Attitude - 360 Degree Feedback Survey Sample #8

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)

You have been selected to provide feedback for the manager listed above. 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.

In responding to the assessment form, please think about your experiences working with this individual during the last six to twelve months. Your responses will be merged with other people's feedback and presented to to guide them in their on-going development. Comments will be shared anonymously, as written, with the manager.

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.

When clicking your selection below, try to best fit the manager's actual behaviors to the scale provided.

If you are not sure, or unable to assess, select "Not Applicable" (N/A) option.

Please complete your response by .


Agree Unsure Disagree N/A
  1. Contributes to a positive and fun work environment.
  1. Visibly supports and encourages diversity in style and background.
  1. Treats all people fairly and with respect.
  1. Builds open and trusting relationships.
  1. Shows by their actions that they trust in the positive intentions of others.


Agree Unsure Disagree N/A
  1. Acts decisively in frequently changing and uncertain environment.
  1. Effective in incorporating new ideas.
  1. Willing to try new ideas.
  1. Adapts to circumstances as needed.
  1. Open to the perspectives/viewpoints of others.

Continual Learning

Agree Unsure Disagree N/A
  1. Shares best practices with others and learns from others.
  1. Grasps new ideas, concepts, technical, or business knowledge.
  1. Sets relevant learning objectives and goals.
  1. Builds on their strengths while addressing their weaknesses.
  1. Pursues self-improvement through continual learning.

Establishing Focus/Direction

Agree Unsure Disagree N/A
  1. Maintains focus when handling several problems or tasks simultaneously.
  1. Stays focused even when under pressure and stress.
  1. Functions well under stress, deadlines, and/or significant workloads.
  1. Maintains self-control when personally criticized.
  1. Helps guide employees with prioritizing tasks.


Agree Unsure Disagree N/A
  1. Uses appropriate techniques to solve problems.
  1. Can effectively interpret and analyze data.
  1. Asks the "right" questions to size up or evaluate situations.
  1. Actively seeks constructive feedback from others.
  1. Analyzes data and information from several sources and arrives at logical conclusions.


Agree Unsure Disagree N/A
  1. Seeks and utilizes opportunities for continuous learning and self-development.
  1. Takes action without being asked.
  1. Takes the initiative to change the direction or course of events.
  1. Goes above and beyond the stated goals.
  1. Prepares for unexpected contingencies.

Results Oriented

Agree Unsure Disagree N/A
  1. Inspires and motivates co-workers to be productive and energetic at work
  1. Demonstrates the personal confidence to "stay the course," even when faced with difficulty
  1. Provides clear expectations for employees.
  1. Does not become distracted by non-issues or interruptions.
  1. Directs team in prioritizing daily work activities


Agree Unsure Disagree N/A
  1. Establishes goals and objectives.
  1. Consistently provides me with timely feedback for improving my performance.
  1. Organizes and schedules events, activities, and resources.
  1. Assures [Company] principles are understood, employed & pursued.
  1. Effectively organizes resources and plans

Interpersonal Skills

Agree Unsure Disagree N/A
  1. Comes across as credible, knowledgeable and sincere
  1. Is a role model for others
  1. Effectively manages conflicts by dealing with them directly and immediately
  1. Able to work with individuals at all levels of the Company.
  1. Uses tact, compassion, and sensitivity in interactions with others.

Client Focus

Agree Unsure Disagree N/A
  1. Ensures client commitments and requirements are met or exceeded
  1. Maintains strong relationships with clients.
  1. Looks for opportunities that have a positive impact on Clients.
  1. Satisfies client needs.
  1. Forms strong client relationships

Co-worker Development

Agree Unsure Disagree N/A
  1. Adapts coaching and mentoring approach to meet the style or needs of individuals
  1. Gives others development opportunities through project assignments and increased job responsibilities
  1. Provides ongoing feedback to co-workers on their development progress
  1. Sets and clearly communicates expectations, performance goals, and measurements to others

  1. Overall, please rate the effectiveness of .

  2. Strengths

  3. Areas for Development

  4. Please give any final comments or suggestions for 's assessment.