Collaboration- 360 Degree Feedback Survey Sample #4

Dear Employee:


Welcome to our 360-Degree Feedback Assessment of [Participant Name]. Our objective is to provide feedback which will help advance his/her leadership skills and capabilities. We are asking you to take time to respond to this survey to help us identify where we are doing well and where we have opportunities to do better.

We have developed this survey with questions tailored for [Participant Name]'s position in the department to provide you with an opportunity to anonymously rate many facets of his/her leadership performance. The survey will assess what you value most in their leadership skills and allow you to make positive suggestions for improvement.

Please be honest, constructive and thoughtful in your responses. The results of this survey will be used to help drive our future success. If you have any questions about the process please contact [Contact Person].

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

Thank you for your participation in the survey. We look forward to seeing the analysis of your responses and we are hoping for 100% participation.

Management Team

Instructions:
Please complete the items below and press the submit button at the end of the survey. If you need multiple sessions to complete the survey, please click the "Submit" button at the end of each session to save your responses. Please feel free to skip any items that you do not wish to respond to. Keep in mind that your responses help us to become a better place to work. So, you are encouraged to respond to all items on the questionnaire.

---

Collaboration	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Identifies and organizes partnerships and alliances.
Works cooperatively with others to solve problems.
Is a trustworthy and credible partner.
Creates a culture that fosters and values collaboration.
Defines shared goals with the committee members.
Integrity	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Demonstrates sincerity in actions with others.
Maintains strong relationships with others.
Protects the integrity and confidentiality of information
Develops trust and confidence from others.
Fosters a high standard of ethics and integrity.
Emotional Intelligence	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is able to express themselves clearly.
Able to understand others' points of view.
Helps employees to resolve conflicts, communicate clearly, and work together to solve problems.
Is able to control their own emotions.
Is attentive to emotional cues and interprets others' feelings correctly.
Flexibility	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Encourages others to adopt new procedures.
Can handle changes without complaining.
Implements changes as a result of having listened to employees
Open to the perspectives/viewpoints of others.
Willing to try new ideas.
Bias for Action	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Identifies ways to simplify work processes and reduce cycle times
Completes a large volume of work.
Encourages risk taking and experimentation to improve performance
Conveys a sense of urgency about addressing problems and opportunities
Completes work on time
Change Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Able to get department employees to accept new changes.
Develops plans for following through on the changes.
Inspires others to want to change.
Is a leading force driving changes.
Effective in implementing new organizational vision and values.
Coaching	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Develops the skills and capabilities of others.
Meets regularly with employees to coach them on areas that will enhance their performance
Helps employees to maintain high personal standards.
Coaches employees in how to strengthen knowledge and skills to improve work performance.
Conducts regular performance appraisals and feedback.
Fiscal Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Develops of the department's annual budget.
Monitors expenses and verifies the need for items purchased.
Ensures others follow the correct rules and regulations on fiscal matters.
Develops budgets and plans for various programs and initiatives.
Effectively manages appropriations, reporting, purchases, expenditures, payrolls, and staff.

41. On a scale of Excellent to Poor, how would you rate your overall employment with [Company] and why?
    

    -Excellent -Good -Average -Poor




42. Would you refer others who are seeking employment to [Company]?
    Yes No
    
    Please provide explanation:
    
    


43. If you had an opportunity to make any change you wanted to make [Company] a better place to work, what one improvement would you make?
    
    
    


44. What changes do you see [Company] making in order to raise the standards?
    
    


45. I feel good about my continued employment with [Company].
    Yes No
    
    If no, please provide explanation:
    
    
    


46. What do you like best about working for [Company]?
    
    


47. What do you like least about working for [Company]? How could it be improved?
    


93. Use the space below to enter any final comments you would like to be noted: