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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)
Survey 13 (4-point scale; numbers; floating anchors)
Survey 14 (4-point scale; N/A)
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.



Edit this Survey
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Collaboration

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Uses group decision making.
  1. Encourages collaboration with other departments.
  1. Encourages team members to offer opinions and ideas.
  1. Encourages collaboration of fellow employees to achieve results.
  1. Encourages open dialog and sharing of information among team members.
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. Demonstrates honesty and truthfulness at all times.
  1. Demonstrates sincerity in actions with others.
  1. Establishes relationships of trust, honesty, fairness, and integrity.
  1. Fosters an environment built upon trust.
  1. Protects the integrity and confidentiality of information
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. Seeks to obtain consensus or compromise.
  1. Ensures stakeholders are involved in the decision making process.
  1. Able to express own goals and needs.
  1. Has excellent influencing/negotiating skills.
  1. Persuades others to consider alternative points of view.
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. Allows subordinates to use their own methods and procedures.
  1. Tells subordinates what to do, not how to do it.
  1. Defines goals and objectives for subordinates.
  1. Entrusts subordinates with important tasks.
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. Makes the most of limited time available.
  1. Effectively delegates tasks to maximize the use of time.
  1. Proactively addresses crucial matters.
  1. Starts projects without delay.
  1. Tackles the biggest problems at the start of the day.
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. Identifies opportunities for improvement before there is a problem.
  1. Creates performance measures to ensure action by the department.
  1. Completes challenging projects successfully despite setbacks.
  1. Is decisive when making decisions.
  1. Approves purchase requests in a timely manner.
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.