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 contribute to a positive work environment.
You work to eliminate unnecessary work or barriers that get in others' way.
You are gracious and professional in your interactions with others.
You build open and trusting relationships.
You show by your actions that you trust in the positive intentions of others.
Flexibility	Agree	Unsure	Disagree	N/A
You can seamlessly transition between various environments and situations.
I am able to increase output to meet increased demand.
You recognize and quickly adapt to shifts in the environment, market, or industry.
You scale up production capabilities in response to growing service demands.
I am flexible in effectively handling changes in production volumes.
Continual Learning	Agree	Unsure	Disagree	N/A
You take the initiative to learn new skills.
You pursue learning that will enhance job performance.
You pursue self-improvement through continual learning.
You participate in regular training offered.
You grasp new ideas, concepts, technical, or business knowledge.
Establishing Focus/Direction	Agree	Unsure	Disagree	N/A
You maintain focus when handling several problems or tasks simultaneously.
You align the department's goals with the goals of the organization.
You maintain self-control when personally criticized.
You make sure that employees understand how their work relates to organizational goals.
You make sure that employees understand and identify with the team's mission.
Analytical	Agree	Unsure	Disagree	N/A
You prioritize various actions to be taken when solving a problem.
You analyze data and information from several sources and arrives at logical conclusions.
You identify problems and issues needing resolution.
You identifiy opportunities for progress and innovation.
You select the appropriate techniques for analysis.
Initiative	Agree	Unsure	Disagree	N/A
You coach others to foster an environment which can adapt quickly and willingly to rapid change.
You take action without being asked.
I clean the workspace without being told.
You confront problems immediately without supervisor instructions.
You initiate actions that impact the department/company.
Results Oriented	Agree	Unsure	Disagree	N/A
I overcome obstacles to continue working toward goals.
I adapt to disruptions in the supply chain to maintain production levels.
I identify what needs to be accomplished.
You complete work on time.
You give extra effort to solve problems and get work done on time.
Objectives	Agree	Unsure	Disagree	N/A
You encourage others to take on greater responsibility.
You effectively organize resources and plans
You set long-term and short-term goals.
You communicate goals and objectives to employees.
You establish goals and objectives.
Interpersonal Skills	Agree	Unsure	Disagree	N/A
You address critical customer issues in a timely manner.
You effectively manage conflicts by dealing with them directly and immediately
You create an atmosphere that supports the open expression of ideas
I am honest about making mistakes and willing to fix them.
You are respectful of the opinions and ideas of others.
Client Focus	Agree	Unsure	Disagree	N/A
I provide training to others on how to improve client service.
You thoroughly understand the needs of the client.
You create high quality products for the clients.
You give feedback to the client regularly.
You anticipate potential obstacles to meeting client needs.
Co-worker Development	Agree	Unsure	Disagree	N/A
You work to identify root causes of performance problems
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 take immediate action on poor performance

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.