Collaboration- 360 Degree Feedback Survey Sample #3





Competencies Included:
Collaboration, Integrity, Persuasion and Influence, Delegation, Time Management, Action
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 asked to evaluate yourself as part of a 360-degree feedback process. Other employees, including your manager(s), peers, and direct reports will also evaluate you. In this manner, you will be provided with a comprehensive, multi-perspective (i.e., 360-degree) view of your performance as a manager. The objective is to provide you with feedback so as to allow you to improve your performance, resulting in improved team performance, and organizational effectiveness.

If you are not able to respond to an item, leave it blank and go on to the next item.

Sample Result Document:
Sample Results
We encourage everyone to complete the survey. Please be honest, constructive and thoughtful in your input. The survey is designed to help us understand more about your thoughts and needs to make this a great company.

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






Collaboration

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Devotes time and energy to empower the team to succeed.
  1. Avoids promoting a hyper competitive culture in favor of a more collaborative one.
  1. Respects and utilizes diverse perspectives in addressing challenges.
  1. Readily shares information with other group members.
  1. Integrates technology to boost collaborative work on process and policy documentation.
Please feel free to provide any comments to help explain your answers?

Integrity

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Establishes relationships of trust, honesty, fairness, and integrity.
  1. Does what was promised.
  1. Accepts responsibility for mistakes.
  1. Maintains strong relationships with others.
  1. Develops trust and confidence from others.
Please feel free to provide any comments to help explain your answers?

Persuasion and Influence

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Understanding what others need.
  1. Ensures stakeholders are involved in the decision making process.
  1. Has excellent influencing/negotiating skills.
  1. Persuades others to consider alternative points of view.
  1. Seeks to obtain consensus or compromise.
Please feel free to provide any comments to help explain your answers?

Delegation

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Allows employees to decide how they wish to complete the tasks.
  1. Sets clear and reasonable expectations for others and follows through on their progress.
  1. Assigns tasks to create learning opportunities for the employees.
  1. Clearly defines duties and tasks to be completed.
  1. Tells subordinates what to do, not how to do it.
Please feel free to provide any comments to help explain your answers?

Time Management

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Proactively addresses crucial matters.
  1. Frequently arrives early to start the day.
  1. Avoids being distracted by people who are working at a slower pace.
  1. Arrives to (attends) meetings on time.
  1. Makes the most of limited time available.
Please feel free to provide any comments to help explain your answers?

Action

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Creates opportunities and then takes advantage of them.
  1. Is decisive when making decisions.
  1. Is not afraid to take corrective action when necessary.
  1. Starts immediately working on assignments.
  1. Does not procrastinate when there is a job to be done.
Please feel free to provide any comments to help explain your answers?

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






  2. Strengths


  3. Areas for Development


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