Coaching- 360 Degree Feedback Survey Sample #8

Instructions

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.

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.



Please complete your response by .

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Coaching	Agree	Unsure	Disagree	N/A
Asks open-ended questions to guide employees to uncover their own answers and insights rather than providing them with direct solutions.
Fosters a sense of progress and possibility.
Provides clear, motivating, and constructive feedback.
Asks employees to define or explain their goals, strategies, and motivations.
Challenges the employee to grow and reflect on their capabilities and opportunities.
Adaptability	Agree	Unsure	Disagree	N/A
Learns new skills to become competitive and contribute to the bottom line.
Implements new rules, procedures, or regulations.
Is aware of changes to team personnel.
Adjusts tactics and strategies.
Changes decision-making processes and strategies as needed.
Action	Agree	Unsure	Disagree	N/A
Avoids "Analysis Paralysis" through action.
Undertakes actions to achieve specific goals.
Acts immediately instead of waiting for someone else to solve the issue.
Seeks out opportunities to contribute beyond assigned responsibilities.
Will take action to address a problem rather than to wait to confer with others about the situation.
Continual Learning	Agree	Unsure	Disagree	N/A
Is open to new ideas and concepts.
Seeks opportunities to grow in skills and knowledge.
Participates in regular training offered.
Pursues learning that will enhance job performance.
Shares best practices with others and learns from others.
Cultural Awareness	Agree	Unsure	Disagree	N/A
Open to learning about different cultures.
Avoids referring to stereotypes about others from different cultures.
Views diversity as a strength, not as an issue.
Actively listens to diverse viewpoints without judgment or dismissal.
Respects the views offered by individuals with different cultural backgrounds.
Persuasion and Influence	Agree	Unsure	Disagree	N/A
Uses knowledge and charisma rather than position, power, or coercion to influence others.
Stays focused on evidence even in emotionally charged discussions, modeling composure and integrity.
Uses influence to shape thinking, not just actions - prompting reflection, reconsideration, or belief shifts.
Develops sales pitches based on the unique needs of the customers.
Gets people to change their minds and alter the way they do things.
Delegation	Agree	Unsure	Disagree	N/A
Entrusts subordinates with important tasks.
Delegates tasks that allow employees to demonstrate leadership potential in safe, supported contexts.
Engages the employee in discussion to ensure alignment on the delegated responsibility.
Delegates specialized tasks to those that have the expertise and knowledge to perform them.
Offers tools, training, and any additional guidance as needed.
Innovation	Agree	Unsure	Disagree	N/A
Uses unconventional approaches to solve problems.
Shares innovative ideas with others.
Facilitates networking events or brainstorming sessions where employees can share insights and inspirations.
Supports changes to the standard way of doing things.
Adjusts creative approaches to ensure they meet both short-term and long-term business goals.
Results Oriented	Agree	Unsure	Disagree	N/A
Builds a supportive environment where enthusiasm and collaboration thrive.
Achieves long and short-term goals.
Identifies what needs to be accomplished.
Breaks down long-term goals into short-term milestones with clear timelines.
Has a positive attitude that encourages others to continue supporting the production goals.
Regulatory/Compliance	Agree	Unsure	Disagree	N/A
Creates necessary compliance policies and procedures.
Is aware of the documents and reports needed to maintain compliance with regulations.
Effectively manages a department of compliance officers.
Documents the performance of compliance audits.
Follows all safety regulations and procedures.

51. Overall, please rate the effectiveness of [Participant Name Here].
    

    5- Very Effective 4- Effective 3- Neither 2- Ineffective 1- Very Ineffective

    
    
52. Strengths
    
    
    
53. Areas for Development
    
    
    
54. Please give any final comments or suggestions for [Participant Name Here]'s assessment.