Collaboration- 360 Degree Feedback Survey Sample #2





Surveys Measuring Collaboration:
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)
Instructions

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 and the goals they were asked to achieve. 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 discussed with the employee to foster growth and on-going development.

Competencies Included:
Collaboration, Partnering/Networking, Communication Skills, Accountability, Decision Making, Goals, Planning, Cultural Awareness, Performance
Sample Result Document:
Sample Results
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.

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


Collaboration

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Makes decisions with other members of the group.
  1. Is a trustworthy and credible partner.
  1. Builds consensus among team members.
  1. Creates a culture that fosters and values collaboration.
  1. Is comfortable working with employees from different departments/divisions.
What are your suggestions for how [Participant Name] can make improvements
in Collaboration?

Partnering/Networking

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Forges mutually beneficial relationships between individuals with diverse backgrounds.
  1. Develops a sense of trust in subordinates so they can freely interact and share information with others.
  1. Maintains infrastructure to support partnerships and networks.
  1. Partners with peers to obtain influence within the Company.
  1. Creates the conditions for partnerships to grow and develop.
What are your suggestions for how [Participant Name] can make improvements
in Partnering/Networking?

Communication Skills

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Able to deliver presentations.
  1. Has the confidence to communicate effectively to all levels (from CEO down) of the organization, external customers, suppliers, as well as the senior counsel of other companies.
  1. Communicates effectively with all levels of the organization.
  1. An effective listener who is responsive to information needs.
  1. Able to demonstrate persuasiveness in pursuit of objectives.
What are your suggestions for how [Participant Name] can make improvements
in Communication Skills?

Accountability

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Accepts accountability for their actions and results.
  1. Accepts personal responsibility for their actions.
  1. Defines roles, rights, and responsibilities of the team.
  1. Accepts accountability for their work.
  1. Upholds ethical standards even when no one is watching.
What are your suggestions for how [Participant Name] can make improvements
in Accountability?

Decision Making

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Is aware of the impact of decisions and informs others about potential outcomes.
  1. Outlines the parameters influencing the decision making process.
  1. Is able to make decisions quickly.
  1. Views the long and short-term impact of decisions.
  1. Makes decisions independently (without having to be told what or how).
What are your suggestions for how [Participant Name] can make improvements
in Decision Making?

Goals

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Makes sure that I have a clear idea of our group's goals.
  1. Achieves established goals.
  1. Understands & contributes to development of strategic goals.
  1. Establishes and documents goals and objectives.
  1. Conducts timely follow-up; keeps others informed on a need to know basis.
What are your suggestions for how [Participant Name] can make improvements
in Goals?

Planning

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Plans for how to allocate time to specific activities.
  1. Assesses the potential impact of changes to the strategic plan.
  1. Open to input from others into the plan for the project.
  1. Works in an organized manner
  1. Allows input from others for the 5-year plan.
What are your suggestions for how [Participant Name] can make improvements
in Planning?

Cultural Awareness

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Accepts individual differences.
  1. Respects the views offered by individuals with different cultural backgrounds.
  1. Understands what customs and etiquette are important for individuals from other cultures.
  1. Recognizes and values individual and cultural differences.
  1. Is aware of the similarities and differences among and between cultural groups.
What are your suggestions for how [Participant Name] can make improvements
in Cultural Awareness?

Performance

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Shown significant improvement in job performance.
  1. Effective in performing his/her job.
  1. Effectively organizes resources and plans
  1. Able to organize work.
  1. Has great overall performance
What are your suggestions for how [Participant Name] can make improvements
in Performance?


  1. Strengths


  2. Areas for Development


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