Coaching- 360 Degree Feedback Survey Sample #8

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)

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. Meets regularly with employees to coach them on areas that will enhance their performance
  1. Provides clear, motivating, and constructive feedback.
  1. Develops the skills and capabilities of others.
  1. Helps employees to maintain high personal standards.
  1. Coaches employees in how to strengthen knowledge and skills to improve work performance.


Agree Unsure Disagree N/A
  1. Flexible and open to new ideas and encourages others to value change.
  1. Adjusts priorities to changing business goals.
  1. Able to adapt to changes in technology and processes.
  1. Learns from personal experiences and/or mistakes.
  1. Is proactive and takes steps to prepare for changes in the workplace.


Agree Unsure Disagree N/A
  1. Effectively makes decisions
  1. Motivates & supports others to gain skills
  1. Does whatever it takes (within reason) to get the job done.
  1. Is not afraid to take corrective action when necessary.
  1. Works quickly when faced with difficult problems.

Continual Learning

Agree Unsure Disagree N/A
  1. Seeks opportunities to grow in skills and knowledge.
  1. Is open to new ideas and concepts.
  1. Takes the initiative to learn new skills.
  1. Improves on their skill sets.
  1. Pursues learning that will enhance job performance.

Cultural Awareness

Agree Unsure Disagree N/A
  1. Shows respect in daily interactions
  1. Treats others with dignity and respect.
  1. Maintains an inclusive work environment that maximizes the talents of others in achieving goals.
  1. Values the opinions of diverse groups and individual.
  1. Encourages a work environment where individual differences are valued.

Persuasion and Influence

Agree Unsure Disagree N/A
  1. Develops a good rapport with others.
  1. Understanding what others need.
  1. Seeks to obtain consensus or compromise.
  1. Has excellent influencing/negotiating skills.
  1. Attempts to persuade others rather than simply control them.


Agree Unsure Disagree N/A
  1. Assigns tasks to create learning opportunities for the employees.
  1. Clearly defines duties and tasks to be completed.
  1. Sets clear and reasonable expectations for others and follows through on their progress.
  1. Delegates authority and responsibility to subordinates and holds them accountable for their actions.
  1. Tells subordinates what to do, not how to do it.


Agree Unsure Disagree N/A
  1. Develops new products and services.
  1. Searches for opportunities and innovative ways to improve the organization.
  1. Takes risks to advance important ideas.
  1. Finds creative ways to get things done with limited resources.
  1. Creates improved methods or solutions for meeting goals and objectives.

Results Oriented

Agree Unsure Disagree N/A
  1. Encourages a high-energy, fun work environment and coaches others on how to do the same
  1. Does not become distracted by non-issues or interruptions.
  1. Provides clear expectations for employees.
  1. Explains the "whys" behind organizational objectives
  1. Demonstrates the personal confidence to "stay the course," even when faced with difficulty


Agree Unsure Disagree N/A
  1. Complies with trade agreements affecting international companies.
  1. Is aware of federal and local laws affecting employees.
  1. Provides documents and reports as needed to maintain compliance with laws.
  1. Is aware of the documents and reports needed to maintain compliance with regulations.
  1. Performs regular compliance audits.

  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.