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 .

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Attitude	Agree	Unsure	Disagree	N/A
You treat all people fairly and with respect.
You work to eliminate unnecessary work or barriers that get in others' way.
You contribute to a positive and fun work environment.
You are gracious and professional in your interactions with others.
You show by your actions that you trust in the positive intentions of others.
Flexibility	Agree	Unsure	Disagree	N/A
You adapt to new organizational structures, policies, or procedures.
You accommodate adaptable scheduling.
I am able to produce goods and services across a wide spectrum of business needs.
You respond to issues and problems with creative solutions and innovation.
You consider other solutions provided by employees.
Continual Learning	Agree	Unsure	Disagree	N/A
You are open to new ideas and concepts.
You take charge of your training and skills enhancement.
You share best practices with others and learn from others.
You pursue professional development opportunities when they arise.
You seek opportunities to grow in skills and knowledge.
Establishing Focus/Direction	Agree	Unsure	Disagree	N/A
You are excellent at managing time.
You help guide employees with prioritizing tasks.
You maintain focus when handling several problems or tasks simultaneously.
You align the department's goals with the goals of the organization.
You stay focused even when under pressure and stress.
Analytical	Agree	Unsure	Disagree	N/A
I critically examine the information presented to determine its truthfulness and applicability to the topic at hand.
You increase understanding through the cautious application of logic and research.
I use statistics to find hidden patterns, connections, and trends in data.
I weigh the risks and costs of certain decisions.
You identify problems and issues needing resolution.
Initiative	Agree	Unsure	Disagree	N/A
I encourage others on the team to suggest process improvements.
You take the initiative to complete tasks ahead of schedule.
I immediately work on solving problems.
I expand the offerings of the department by working evenings and weekends.
When working on a problem in a team, I often am the first to suggest possible solutions.
Results Oriented	Agree	Unsure	Disagree	N/A
I persist in seeking objectives despite obstacles or setbacks.
You respond to changing events to maintain progress toward achieving results.
I quickly analyze the situation to determine the most pressing needs.
I determine what resources will be needed to achieve the objectives.
I can adapt to new procedures to maintain production capacities.
Objectives	Agree	Unsure	Disagree	N/A
You are able to establish realistic goals.
You set long-term and short-term goals.
You communicate goals and objectives to employees.
You consistently provide me with timely feedback for improving my performance.
You effectively organize resources and plans
Interpersonal Skills	Agree	Unsure	Disagree	N/A
You use tact, compassion, and sensitivity in interactions with others.
I value the input from coworkers.
You are respectful of the opinions and ideas of others.
You demonstrate good communication with colleagues and customers.
I am honest about making mistakes and willing to fix them.
Client Focus	Agree	Unsure	Disagree	N/A
I am competent in handling difficult clients.
I deliver customized solutions for each client.
I am competent in managing client projects.
You consistently demonstrate a client focus.
You document client interactions.
Co-worker Development	Agree	Unsure	Disagree	N/A
You take immediate action on poor performance
You give others development opportunities through project assignments and increased job responsibilities
You adapt coaching and mentoring approach to meet the style or needs of individuals
You set and clearly communicate expectations, performance goals, and measurements to others
You work to identify root causes of performance problems

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.