Bias for Action - 360 Degree Feedback Survey Sample #9

360 Feedback Survey

Self-Assessment Instructions

Thank you for agreeing to participate in this leadership training process. As part of this process, you will be completing the self-assessment questionnaire (below). As you respond, please draw on your work experiences over the past 12 months. Rate each item using the scale shown. Comments at the end can help you to explain your ratings. If you gave a particularly high or low rating, please share your reasons in the comment section for that competency. Your responses will be compiled with feedback from others and presented to you at the next leadership seminar to help guide your ongoing professional development.

Partially completed forms can be saved by using the Save/Still Working button at the bottom of the page. You may return at a later time to complete/edit the form. Your saved responses will be shown each time you re-visit the feedback form. When you are certain that you have completed your responses and will be not making any changes, click the Complete button.

Bias for Action	Definite Strength	Meets Standards	Needs Development	N/A
You complete work on time
You convey a sense of urgency about addressing problems and opportunities
You complete a large volume of work.
You encourage risk taking and experimentation to improve performance
You display high energy and enthusiasm on consistent basis.
Communication Skills	Definite Strength	Meets Standards	Needs Development	N/A
You are an effective communicator
You have the confidence to communicate effectively to all levels (from ceo down) of the organization, external customers, suppliers, as well as the senior counsel of other companies.
You listen to others' points of view with an open mind
You are able to demonstrate persuasiveness in pursuit of objectives.
You convey ideas confidently and succinctly.
Flexibility	Definite Strength	Meets Standards	Needs Development	N/A
You act decisively in frequently changing and uncertain environment.
You work effectively during periods of change.
You identify new opportunities to achieve goals
You implement changes as a result of having listened to employees
You encourage others to adopt new procedures.
Emotional Intelligence	Definite Strength	Meets Standards	Needs Development	N/A
You are able to express yourself clearly.
You are able to manage your own emotions.
You accurately perceive the emotional reactions of others.
You help employees to resolve conflicts, communicate clearly, and work together to solve problems.
You are able to understand others' points of view.
Managing Performance	Definite Strength	Meets Standards	Needs Development	N/A
You provide employees with training as needed to increase their performance.
You adjust performance goals as needed to meet the demands of the department/organization.
You ensure that team goals are met 85 percent of the time.
You obtain commitment from employees regarding completion of tasks.
You set and maintain high standards for self and others.
Analytical	Definite Strength	Meets Standards	Needs Development	N/A
You identify problems and issues needing resolution.
You select the appropriate techniques for analysis.
You implement data validation techniques and methods.
You identifiy opportunities for progress and innovation.
You use appropriate techniques to solve problems.
Goals	Definite Strength	Meets Standards	Needs Development	N/A
You achieve goals.
You set challenging stretch goals
You set high expectations and goals; encourages others to support the organization.
You make sure that team members have a clear idea of our group's goals.
You achieve established goals.
Technology Use/Management	Definite Strength	Meets Standards	Needs Development	N/A
You identify gaps between actual and needed technical competencies and provide recommendations for required training.
You use technology in decision making and problem solving.
You support technical training and development of employees.
You understand and are committed to implementing new technologies.
You apply complex rules and regulations to maintain optimal system performance.
Customer Focus	Definite Strength	Meets Standards	Needs Development	N/A
You consistently model positive customer service attitudes.
You develop good rapport and trust with the customer.
You do not hesitate to address customer concerns or complaints.
You maintain positive customer relationships.
You develop strong customer relationships.
Negotiation	Definite Strength	Meets Standards	Needs Development	N/A
You influence others through rational argument and persuasion.
You are able to clearly express thoughts and concerns.
You actively listen to conversations to be able to recall important details later.
You resolve difficult negotiations whether it is a contract, sub contract, legal or any other difficult negotiation fairly and reasonably.
You are able to adapt to changing situations.
Others	Definite Strength	Meets Standards	Needs Development	N/A
You form working relationships with employees from other departments.
You respect the opinions of other employees.
You support the efforts of other employees in implementing solutions to problems.
You are able to see issues from others' perspectives.
You work effectively with people from other departments.

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.