Change Management - 360 Degree Feedback Survey Sample #11

360 Feedback Survey

Questionnaires Measuring Change Management:
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)

Thank you for providing feedback for the recipient above. As you respond, please draw on your first-hand experience with this individual in the past 12 months. Rate each item using the scale shown. If you don't feel you have enough first-hand information to rate a certain item, please choose the Not Applicable option. Comments can be very helpful; at a minimum where you give 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 the recipient to help guide their ongoing 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.

To what extent does [Participant Name] exhibit the following ...

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

Change Management

What does Change Management mean?
It means that ...
  • You support new initiatives for organizational changes to improve effectiveness.
  • You support the Company's efforts to implement changes.
  • You are effective in implementing new organizational vision and values.
  • You assist others in understanding changes to the organization.
  • You adopt changes to set and example for others to follow.

To what extent does this person exhibit Change Management?
Select from one of the ratings below.

Problem Solving

What does Problem Solving mean?
It means that ...
  • You are able to solve problems at root cause rather than at symptom level.
  • You are effective in solving problems.
  • You can develop innovative solutions to problems.
  • You are a good problem solver and decision maker
  • You solve problems using logic and insight.

To what extent does this person exhibit Problem Solving?
Select from one of the ratings below.

Conflict Management

What does Conflict Management mean?
It means that ...
  • You assist team members by helping them see the other point of view.
  • You clearly express expectations to others.
  • You deal effectively with employee grievances.
  • You identify and takes steps to prevent potential confrontations.
  • You try to understand others' point of view before making judgments

To what extent does this person exhibit Conflict Management?
Select from one of the ratings below.


What does Punctuality mean?
It means that ...
  • You maintain an efficient schedule of activities.
  • You avoid making personal phone calls during working hours.
  • You conduct appointments at scheduled start time.
  • You start meetings on time.
  • You invoice clients on a timely basis.

To what extent does this person exhibit Punctuality?
Select from one of the ratings below.


What does Planning mean?
It means that ...
  • You make plans and follows through.
  • You work in an organized manner
  • You delegate role to team members to accomplish goals.
  • You anticipate obstacles and ways to overcome them.
  • You are able to look ahead (beyond the present) when addressing the work/needs of the department.

To what extent does this person exhibit Planning?
Select from one of the ratings below.

Areas for Development

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