Bias for Action - 360 Degree Feedback Survey Sample #8

Questionnaires Measuring Bias for Action:
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 .

Bias for Action

Agree Unsure Disagree N/A
  1. Completes a large volume of work.
  1. Conveys a sense of urgency about addressing problems and opportunities
  1. Motivates others to achieve or exceed goals
  1. Identifies ways to simplify work processes and reduce cycle times
  1. Projects a "can-do" attitude when interfacing with peers, subordinates and customers(especially during difficult and challenging times).

Supervisory Skills

Agree Unsure Disagree N/A
  1. Treats all staff equitably.
  1. Maintains good working relationships with employees.
  1. Provides constructive, ongoing feedback.
  1. Is aware of the unique strengths of each employee.
  1. Encourages employees to achieve their full potential.


Agree Unsure Disagree N/A
  1. Delegates tasks, responsibilities, and accountability as appropriate to the level of employee.
  1. Sets clear and reasonable expectations for others and follows through on their progress.
  1. Encourages and empowers subordinates to use initiative in achieving goals and objectives.
  1. Allows subordinates to use their own methods and procedures.
  1. Delegates authority and responsibility to subordinates and holds them accountable for their actions.


Agree Unsure Disagree N/A
  1. Analyze what occurred and re-adjusts accordingly when goals are not met.
  1. Encourages employees to produce the best quality products.
  1. Corrects issues in a timely manner.
  1. Encourages others to achieve high quality standards.
  1. Encourages others to produce the highest quality work products.

Change Management

Agree Unsure Disagree N/A
  1. Supports new initiatives for organizational changes to improve effectiveness.
  1. Effective in dealing with ambiguous and challenging situations.
  1. Effective in implementing new organizational vision and values.
  1. Assists others in understanding changes to the organization.
  1. Supports the Company's efforts to implement changes.

Managing Risk

Agree Unsure Disagree N/A
  1. Rewards innovative experiments to try new ideas.
  1. Effectively responds to critical situations to reduce potential for losses.
  1. Bases decisions on patterns found in fluid/changing information.
  1. Able to adapt quickly to changing situations.
  1. Works within constraints of the organization.


Agree Unsure Disagree N/A
  1. Keeps informed of various regulations and procedures.
  1. Ensures regulations are followed as required.
  1. Performs audits regularly, or without notice, to ensure proper compliance with regulations.
  1. Explains regulations and procedures to others as required.
  1. Follows all safety regulations and procedures.


Agree Unsure Disagree N/A
  1. Provides clear, motivating, and constructive feedback.
  1. Helps employees to understand responsibilities, authority, and expectations.
  1. Coaches employees in how to strengthen knowledge and skills to improve work performance.
  1. Develops the skills and capabilities of others.
  1. Addresses employee behavior problems effectively.

Strategic Insight

Agree Unsure Disagree N/A
  1. Formulates strategies and action plans to ensure successful completion of goals and objectives.
  1. Analyzes unique issues or problems impacting the Company.
  1. Identifies potential problems before they become critical incidents.
  1. Maintains knowledge of current trends in the industry.
  1. Implements long-term solutions to problems.

Organizational Fluency

Agree Unsure Disagree N/A
  1. Anticipates problems that may affect the department.
  1. Is aware of other organizational cultures to compare/contrast with the current organizational culture.
  1. Effective in communicating with others within the organization.
  1. Gets things done through the department.
  1. Able to use corporate politics to advance department objectives.

  1. Overall, please rate the effectiveness of .

  2. Strengths

  3. Areas for Development

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