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)
Survey 10 (Comment boxes only)
Survey 11 (Single rating per competency)
Survey 12 (Slide-bar scale)

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. Coach others to foster an environment which can adapt quickly and willingly to rapid change.
  1. Completes a large volume of work.
  1. Conveys a sense of urgency about addressing problems and opportunities
  1. Projects a "can-do" attitude when interfacing with peers, subordinates and customers(especially during difficult and challenging times).
  1. Displays high energy and enthusiasm on consistent basis.

Supervisory Skills

Agree Unsure Disagree N/A
  1. Promotes teamwork and cooperation within the department.
  1. Provides constructive, ongoing feedback.
  1. Appropriately recognizes and rewards employees.
  1. Encourages employees to achieve their full potential.
  1. Treats all staff equitably.


Agree Unsure Disagree N/A
  1. Sets clear and reasonable expectations for others and follows through on their progress.
  1. Defines the roles, responsibilities, required actions, and deadlines for team members.
  1. Allows subordinates to use their own methods and procedures.
  1. Tells subordinates what to do, not how to do it.
  1. Clearly defines duties and tasks to be completed.


Agree Unsure Disagree N/A
  1. Always strives to produce the highest quality work products.
  1. Analyze what occurred and re-adjusts accordingly when goals are not met.
  1. Encourages others to achieve high quality standards.
  1. Reflects on what is working and what could be improved.
  1. Encourages others to produce the highest quality work products.

Change Management

Agree Unsure Disagree N/A
  1. Supports the Company's efforts to implement changes.
  1. Addresses organizational and departmental resistance to changes.
  1. Assists others in understanding changes to the organization.
  1. Works cooperatively with others to implement changes.
  1. Effective in dealing with ambiguous and challenging situations.

Managing Risk

Agree Unsure Disagree N/A
  1. Able to adapt quickly to changing situations.
  1. Bases decisions on patterns found in fluid/changing information.
  1. Seeks to retain the best and brightest employees.
  1. Works within constraints of the organization.
  1. Recognizes that small changes may snowball into major events.


Agree Unsure Disagree N/A
  1. Follows all safety regulations and procedures.
  1. Explains regulations and procedures to others as required.
  1. Keeps informed of various regulations and procedures.
  1. Addresses issues quickly before they develop into major problems.
  1. Understands the applicable regulations and laws that impact our business.


Agree Unsure Disagree N/A
  1. Meets regularly with employees to coach them on areas that will enhance their performance
  1. Provides clear, motivating, and constructive feedback.
  1. Develops the skills and capabilities of others.
  1. Helps employees to understand responsibilities, authority, and expectations.
  1. Addresses employee behavior problems effectively.

Strategic Insight

Agree Unsure Disagree N/A
  1. Communicates vision for the department and company.
  1. Identifies potential problems before they become critical incidents.
  1. Understands the Company's strengths and weaknesses and uses this information to create optimal solutions to problems.
  1. Formulates strategies and action plans to ensure successful completion of goals and objectives.
  1. Maintains knowledge of current trends in the industry.

Organizational Fluency

Agree Unsure Disagree N/A
  1. Understands the current organizational culture.
  1. Understands departmental policies and procedures.
  1. Effective in communicating with others within the organization.
  1. Able to explain departmental policies and procedures to others.
  1. Gets things done through the department.

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

  2. Strengths

  3. Areas for Development

  4. Please give any final comments or suggestions for [Participant Name Here]'s assessment.