Change Management - 360 Degree Feedback Survey Sample #14

360 Feedback Survey

Instructions

Our company is excited to introduce a new web-based survey tool designed to gather comprehensive feedback on core competencies and role responsibilities critical to the ongoing success of our organization. The Leadership Team Members have unanimously agreed to participate in this initiative and are actively seeking your valuable feedback.

In this context, you have been specifically selected to provide insights on the manager listed above. Your feedback is a crucial component of our company's leadership development process. This tool is intended to capture broad and detailed feedback on the essential competencies and responsibilities that underpin our organization's sustained success and growth.

Your thoughtful and candid responses will play a significant role in guiding the professional development of our leadership team. By reflecting on your experiences and interactions with the manager over the past six to twelve months, you will help us identify strengths, areas for improvement, and opportunities for growth. Your feedback will be combined with that of others and presented to the manager to support their ongoing development. Rest assured, your comments will be shared anonymously, ensuring your privacy while contributing to a culture of continuous improvement and excellence.

In responding to the assessment form, please think about your experiences working with this individual during the last twelve (12) months. Your responses will be merged with other people's feedback and presented to guide them in their on-going development. Comments will be shared anonymously, as written, with the manager, unless you indicate otherwise.

You are only being asked to rate 8 competencies. Each competency will have a variety of statements that are grouped by 4 Performance Levels. Click on the level that best describes this individual.

Please ensure that your submission is made between .

Change Management	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Able to get team members to change their attitudes.
Supports new initiatives for organizational changes to improve effectiveness.
Able to get department employees to accept new changes.
Effective in dealing with ambiguous and challenging situations.
Develops plans for following through on the changes.
Is an inspiration for others to accept the recent changes.
Adopts changes to set and example for others to follow.
Inspires others to want to change.
Is a leading force driving changes.
If [Participant Name] were to make improvements in Change Management, what are your suggestions for how he/she can improve this?
Objectives	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Ability to establish realistic goals.
Establishes goals and objectives.
Encourages me to take on greater responsibility.
Consistently provides me with timely feedback for improving my performance.
Organizes and schedules events, activities, and resources.
Able to organize work.
If [Participant Name] were to make improvements in Objectives, what are your suggestions for how he/she can improve this?
Interpersonal Skills	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Is a committed and reliable partner.
Builds strong relationships with team members.
Demonstrates a high degree of ethics and integrity in the workplace.
Builds a strong rapport with co-workers.
Willing to overlook personal differences and focus on completing the task at hand.
Is a highly respected individual in the company.
If [Participant Name] were to make improvements in Interpersonal Skills, what are your suggestions for how he/she can improve this?
Collaboration	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Displays a high degree of trust and credibility.
Committed to fostering a collaborative work environment in the department.
Gains the cooperation of others to accomplish common goals and objectives.
Open to feedback and willing to share insights to foster a collaborative work environment where everyone feels empowered to contribute.
Encourages team members to offer opinions and ideas.
Keeps everyone aligned and motivated to maintain a cohesive and productive team.
If [Participant Name] were to make improvements in Collaboration, what are your suggestions for how he/she can improve this?
Accountability	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Ensures that employee objectives are aligned with the organization's objectives.
Reviews performance to determine areas for improvement.
Takes ownership of problems to find the best solutions.
Requires employees to submit monthly reports of the work they performed.
Works diligently for the success of the team.
Exhibits a sense of ownership of outcomes and results.
If [Participant Name] were to make improvements in Accountability, what are your suggestions for how he/she can improve this?
Establishing Focus/Direction	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Helps guide employees with prioritizing tasks.
Aligns the department's goals with the goals of the organization.
Functions well under stress, deadlines, and/or significant workloads.
Makes sure that employees understand how their work relates to organizational goals.
Excellent at managing time.
Sets appropriate goals for employees.
If [Participant Name] were to make improvements in Establishing Focus/Direction, what are your suggestions for how he/she can improve this?
Developing Others	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Creates opportunities for professional development.
Assesses employees' developmental needs.
Creates a work environment that fosters positive feedback to employees.
Sets performance objectives for subordinates that encourages development opportunities.
Provides constructive feedback to others.
Tries to ensure employees are ready to move to the next level.
If [Participant Name] were to make improvements in Developing Others, what are your suggestions for how he/she can improve this?

46. Strengths
    
    
    
47. Areas for Development
    
    
    
48. Please give any final comments or suggestions for [Participant Name Here]'s assessment.