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.

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Collaboration	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Builds consensus among partners.
Identifies and organizes partnerships and alliances.
Encourages collaboration with other departments.
Is comfortable working with employees from different departments/divisions.
Encourages collaboration of fellow employees to achieve results.
Integrity	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Follows tasks to completion.
Demonstrates sincerity in actions with others.
Protects the integrity and confidentiality of information
Maintains strong relationships with others.
Fosters an environment built upon trust.
Emotional Intelligence	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Accurately perceives the emotional reactions of others.
Is attentive to emotional cues and interprets others' feelings correctly.
Is able to manage their own emotions.
Helps to make decisions and solve problems using knowledge about how others will react in certain situations.
Able to understand others' points of view.
Flexibility	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is open to alternative ways to accomplish goals
Identifies new opportunities to achieve goals
Adapts to new organizational structures, policies, or procedures.
Open to the perspectives/viewpoints of others.
Able to adapt to new situations.
Bias for Action	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Projects a "can-do" attitude when interfacing with peers, subordinates and customers(especially during difficult and challenging times).
Completes a large volume of work.
Completes work on time
Motivates others to achieve or exceed goals
Coach others to foster an environment which can adapt quickly and willingly to rapid change.
Change Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Supports the Company's efforts to implement changes.
Adopts changes to set and example for others to follow.
Effective in implementing new organizational vision and values.
Assists others in understanding changes to the organization.
Works cooperatively with others to implement changes.
Coaching	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Meets regularly with employees to coach them on areas that will enhance their performance
Helps employees to maintain high personal standards.
Addresses employee behavior problems effectively.
Helps employees to understand responsibilities, authority, and expectations.
Develops the skills and capabilities of others.
Fiscal Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Monitors expenses and verifies the need for items purchased.
Monitors spending.
Effectively manages appropriations, reporting, purchases, expenditures, payrolls, and staff.
Keeps excellent records for financial transparency.
Develops budgets and plans for various programs and initiatives.

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: