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Coaching- 360 Degree Feedback Survey Sample #1





360-Degree Feedback Survey

Questionnaires Measuring Coaching:
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:

[Company] is conducting a 360-Degree Feedback Assessment developed by HR-Survey for selected managers.

You have been selected to provide feedback on the employee listed above. Your feedback is an important part of our company's leadership development process and this survey 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 questions below, think about your experiences working with this employee over the last twelve months. The effectiveness of this development tool is dependent on your honest, forthright and constructive responses so please bear this in mind as you answer each question. Your responses will be aggregated with the responses received from others and discussed with the employee to foster growth and on-going 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.

Competencies Included:
Coaching, Communication Skills, Self Management, Punctuality, Performance, Goals, Excellence, Responsible, Entrepreneurship, Company
Sample Result Document:
Sample Results
Your feedback is valuable in helping the individual to understand how they are perceived and experienced by others and the impact their behavior has on people in the organization with whom they interact. Feedback received also acknowledges strengths and identifies areas for development.

Use the form below to provide your feedback. Each field and comment box requires a response before you can SUBMIT your final feedback.

Please ensure that your submission is made between . The survey will only be available during these dates.

Thank you for your participation in the survey. We look forward to seeing the analysis of your responses and we are hoping for 100% participation.

Management Team
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Coaching

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Helps employees to maintain high personal standards.
  1. Provides clear, motivating, and constructive feedback.
  1. Addresses employee behavior problems effectively.
  1. Helps employees to understand responsibilities, authority, and expectations.
  1. Meets regularly with employees to coach them on areas that will enhance their performance
If [Participant Name] were to make improvements in Coaching, what are your suggestions for how he/she can improve this?

Communication Skills

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Clarifies problems logically, simplifying complex matters into digestible parts.
  1. Willing to communicate issues and concerns to colleagues.
  1. Listens to others' points of view with an open mind
  1. Willing to accept feedback from others.
  1. Uses ideas and perspectives to persuade others.
If [Participant Name] were to make improvements in Communication Skills, what are your suggestions for how he/she can improve this?

Self Management

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Uses patience and self-control in working with customers and associates.
  1. Analyzes own reactions on the spot to ensure that communication does not appear to be driven by anger.
  1. Is aware of personal impact on others and adjusts behavior to create a positive leadership presence.
  1. Analyzes interpersonal problems instead of reacting to them.
  1. Does not allow own emotions to interfere with the performance of others.
If [Participant Name] were to make improvements in Self Management, what are your suggestions for how he/she can improve this?

Punctuality

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Starts the workday when scheduled.
  1. Starts meetings on time.
  1. Conducts appointments at scheduled start time.
  1. Avoids making personal phone calls during working hours.
  1. Invoices clients on a timely basis.
If [Participant Name] were to make improvements in Punctuality, what are your suggestions for how he/she can improve this?

Performance

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Has great overall performance
  1. ...Produce Quality
  1. Works effectively in the department.
  1. Works well in this position.
  1. ...Overall Performance
If [Participant Name] were to make improvements in Performance, what are your suggestions for how he/she can improve this?

Goals

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Achieves goals.
  1. Goal Setting
  1. Sets high expectations and goals; encourages others to support the organization.
  1. Makes sure that I have a clear idea of our group's goals.
  1. Establishes and documents goals and objectives.
If [Participant Name] were to make improvements in Goals, what are your suggestions for how he/she can improve this?

Excellence

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Demonstrates the functional or technical skills necessary to do their job.
  1. Demonstrates the analytical skills to do their job.
  1. Is planful and organized.
  1. Produces high quality work.
  1. Takes a lot of pride in their work.
If [Participant Name] were to make improvements in Excellence, what are your suggestions for how he/she can improve this?

Responsible

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Is a person you can trust.
  1. Responsible for setting the vision of the department.
  1. Behavior is ethical and honest.
  1. Completes assigned work tasks.
  1. Acts as a resource without removing individual responsibility.
If [Participant Name] were to make improvements in Responsible, what are your suggestions for how he/she can improve this?

Entrepreneurship

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Exhibits determination and passion in completion of goals.
  1. Excellent at managing relationships with stakeholders.
  1. Takes the initiative to complete tasks.
  1. Maintains a high level of energy to respond to demands of the job.
  1. Seeks and utilizes mentors to help guide professional development.
If [Participant Name] were to make improvements in Entrepreneurship, what are your suggestions for how he/she can improve this?

Company

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Attends [Company] gatherings and social events.
  1. Expresses loyalty and dedication to [Company] in interactions with others.
  1. Understands the "basics" as to how [Company] functions/operates.
  1. Understands how decisions impact other business units beyond their immediate department of work group.
  1. Understands the use of [Company] products and services.
If [Participant Name] were to make improvements in Company, what are your suggestions for how he/she can improve this?

  1. What are [Participant Name Here]'s greatest strengths demonstrated this year?


  2. What are [Participant Name Here]'s areas for development?


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