Bias for Action - 360 Degree Feedback Survey Sample #12





360 Feedback Survey

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)
Survey 13 (4-point scale; numbers; floating anchors)
Survey 14 (4-point scale; N/A)
Instructions

We appreciate you taking the time to provide valuable feedback for the individual mentioned above. As you respond, please draw on your first-hand experience with this individual in the past 12 months. Your insights are crucial in offering a comprehensive evaluation. Please rate each item using the scale provided. If you find that you do not have sufficient first-hand knowledge to rate a particular item, select the Not Applicable option.

In addition to the ratings, we encourage you to include comments where possible. These comments are particularly useful when you give a very high or very low rating, as they provide context and clarity regarding your assessment. Explaining your reasons in the comment section helps ensure that your feedback is constructive and actionable.

Your responses, combined with feedback from other contributors, will be compiled and presented to the individual. This collective feedback aims to support their continuous growth and development by highlighting strengths and identifying areas for improvement. Your thoughtful participation is essential in helping them achieve their full potential.

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.

Sample Result Document:
Sample Results
To what extent does [Participant Name] exhibit the following ...

SELECT the rating that best reflects the employee's performance in the areas listed.


Bias for Action

  • Projects a "can-do" attitude when interfacing with peers, subordinates and customers(especially during difficult and challenging times).
  • Encourages risk taking and experimentation to improve performance
  • Seeks and utilizes opportunities for continuous learning and self-development.
  • Displays high energy and enthusiasm on consistent basis.
  • Completes a large volume of work.
Needs
Improvement
Fully
Proficient
Excels/
Role Model






Click this box to make your rating
Comments:

Cultural Awareness

  • Actively listens to other employees' stories about their culture.
  • Seeks out different viewpoints and benefits from different perspectives.
  • Seeks knowledge and information about other cultures.
  • Effective in working with individuals with a variety of cultural backgrounds.
  • Willing to work with employees who have different cultural backgrounds.
Needs
Improvement
Fully
Proficient
Excels/
Role Model






Click this box to make your rating
Comments:

Innovation

  • Supports changes to the standard way of doing things.
  • Takes risks that often yield rewards.
  • Plays a pivotal role in fostering an environment where radical innovation can flourish and lead to major breakthroughs.
  • Identifies the opportunities created by innovations.
  • Searches for opportunities and innovative ways to improve the organization.
Needs
Improvement
Fully
Proficient
Excels/
Role Model






Click this box to make your rating
Comments:

Co-worker Development

  • Sets and clearly communicates expectations, performance goals, and measurements to others
  • Works to identify root causes of performance problems
  • Takes immediate action on poor performance
  • Adapts coaching and mentoring approach to meet the style or needs of individuals
  • Provides ongoing feedback to co-workers on their development progress
Needs
Improvement
Fully
Proficient
Excels/
Role Model






Click this box to make your rating
Comments:

Planning

  • Encourages others to follow the plan.
  • Develops plans to help manage expectations and project demands.
  • Understands the process for developing strategic plans for the organization.
  • Delegates role to team members to accomplish goals.
  • Notifies staff when the plan is not on schedule.
Needs
Improvement
Fully
Proficient
Excels/
Role Model






Click this box to make your rating
Comments:
Strengths


Areas for Development


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