Clarity - 360 Degree Feedback Survey Sample #8

Questionnaires Measuring Clarity:
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 .


Agree Unsure Disagree N/A
  1. Checks details thoroughly.
  1. Uses appropriate grammar and tense in communications.
  1. Avoids stating unclear or conflicting goals.
  1. Communicates ideas and facts clearly and effectively in writing.
  1. Seeks to reduce ambiguity in messaging and documents.


Agree Unsure Disagree N/A
  1. Acts decisively in frequently changing and uncertain environment.
  1. Identifies new opportunities to achieve goals
  1. Can handle changes without complaining.
  1. Is open to alternative ways to accomplish goals
  1. Implements changes as a result of having listened to employees

Continual Learning

Agree Unsure Disagree N/A
  1. Participates in regular training offered.
  1. Pursues professional development opportunities when they arise.
  1. Pursues learning that will enhance job performance.
  1. Builds on their strengths while addressing their weaknesses.
  1. Seeks opportunities to grow in skills and knowledge.


Agree Unsure Disagree N/A
  1. Treats all people fairly and with respect.
  1. Contributes to a positive work environment.
  1. Builds open and trusting relationships.
  1. Works to eliminate unnecessary work or barriers that get in others' way.
  1. Visibly supports and encourages diversity in style and background.

Managing Performance

Agree Unsure Disagree N/A
  1. Addresses poor performance sooner rather than later.
  1. Establishes indicators to measure levels of performance.
  1. Reviews job performance shortly after completion of tasks.
  1. Ensures employees understand the goals of the organization/department.
  1. Ensures team members understand the department goals.


Agree Unsure Disagree N/A
  1. Establishes and documents goals and objectives.
  1. Conducts timely follow-up; keeps others informed on a need to know basis.
  1. Makes sure that I have a clear idea of our group's goals.
  1. Goal Setting
  1. Achieves established goals.

Results Oriented

Agree Unsure Disagree N/A
  1. Provides clear expectations for employees.
  1. Explains the "whys" behind organizational objectives
  1. Directs team in prioritizing daily work activities
  1. Helps others when free-time is available.
  1. Stays focused on meeting the needs of customers.


Agree Unsure Disagree N/A
  1. Organizes and schedules events, activities, and resources.
  1. Ability to establish realistic goals.
  1. Assures [Company] principles are understood, employed & pursued.
  1. Encourages me to take on greater responsibility.
  1. Consistently provides me with timely feedback for improving my performance.


Agree Unsure Disagree N/A
  1. Recognizes team members who offer a significant contribution to a project.
  1. Finds opportunities to recognize others.
  1. Is sincerely interested in the suggestions of co-workers
  1. Recognizes the abilities and skills of self and others
  1. Readily shares credit and gives others opportunity for visibility.

  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.