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.

Sample Result Document:
Sample Results
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. Encourages risk taking and experimentation to improve performance
  1. Completes work on time
  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. Facilitates open communication between employees.
  1. Effective in resolving conflicts to mutual satisfaction of the parties.
  1. Fosters a positive work environment in the department.
  1. Has a strong work ethic that inspires others.
  1. Enhances teamwork through good supervision.


Agree Unsure Disagree N/A
  1. Encourages and empowers subordinates to use initiative in achieving goals and objectives.
  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. Defines the roles, responsibilities, required actions, and deadlines for team members.
  1. Allows subordinates to use their own methods and procedures.


Agree Unsure Disagree N/A
  1. Holds employees accountable for their quality of work.
  1. Encourages others to achieve high quality standards.
  1. Encourages employees to produce the best quality products.
  1. Always strives to produce the highest quality work products.
  1. Corrects issues in a timely manner.

Change Management

Agree Unsure Disagree N/A
  1. Supports new initiatives for organizational changes to improve effectiveness.
  1. Addresses organizational and departmental resistance to changes.
  1. Able to get team members to change their attitudes.
  1. Is an inspiration for others to accept the recent changes.
  1. Effective in dealing with ambiguous and challenging situations.

Managing Risk

Agree Unsure Disagree N/A
  1. Develops appropriate strategies to minimize risks.
  1. Seeks to maintain the long-term viability of the Company.
  1. Attends risk management seminars and conferences.
  1. Is concerned about process safety management.
  1. Develops policies to address risk situations in the workplace.


Agree Unsure Disagree N/A
  1. Knows who to contact at various regulatory agencies if needed.
  1. Is aware of federal and local laws affecting employees.
  1. Performs audits regularly, or without notice, to ensure proper compliance with regulations.
  1. Reviews skill levels of employees in areas of policies and regulations to identify gaps where additional training is needed.
  1. Understands the applicable regulations and laws that impact our business.


Agree Unsure Disagree N/A
  1. Develops the skills and capabilities of others.
  1. Helps employees to understand responsibilities, authority, and expectations.
  1. Addresses employee behavior problems effectively.
  1. Conducts regular performance appraisals and feedback.
  1. Provides clear, motivating, and constructive feedback.

Strategic Insight

Agree Unsure Disagree N/A
  1. Formulates policies and strategies for addressing the Company's important challenges.
  1. Anticipates business cycles and trends and makes adjustments in a timely manner.
  1. Formulates strategies and action plans to ensure successful completion of goals and objectives.
  1. Maintains knowledge of current trends in the industry.
  1. Implements long-term solutions to problems.

Organizational Fluency

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

  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.