Commitment to Result - 360 Degree Feedback Survey Sample #2





Questionnaires Measuring Commitment to Results:
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)
Self-Assessment Instructions

You have been asked to complete a self-assessment questionnaire form (shown below). You will also receive feedback from others such as your peers, direct reports and manager. 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 as an employee over the last twelve months and the goals you 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 become part of the assessment process to foster your growth and on-going development.

Competencies Included:
Commitment To Result, Decision Making, Communication Skills, Leadership, Innovation, Juggling Multiple Responsibilities, Clarity, Managing Risk, Interpersonal Skills, Responsible, Co-worker Development, Global Perspective
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.


Commitment To Result

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You are willing to do whatever it takes-not afraid to have to put in extra effort.
  1. You take immediate action toward goals.
  1. You are able to focus on a task even when working alone.
  1. You are committed to the team.
What are your suggestions for how you can make improvements
in Commitment To Result?

Decision Making

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You understand factors are important for deciding if a decision is "worth it"?
  1. I make good decisions for the Department.
  1. You remain focused on the immediate goal when making decisions.
  1. You assess the risks, benefits, and potential impact of a number of options when deciding a course of action
What are your suggestions for how you can make improvements
in Decision Making?

Communication Skills

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You ask follow-up questions as needed.
  1. I clarify problems logically, simplifying complex matters into digestible parts.
  1. You check for understanding throughout conversations or group presentations/discussions
  1. You deliver clear and concise instructions.
What are your suggestions for how you can make improvements
in Communication Skills?

Leadership

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You give direct, constructive, and actionable feedback.
  1. You are able to align manpower, design work, an allocate tasks to achieve goals.
  1. You sit down regularly with employees to review your job performance.
  1. You set clear goals and objectives for subordinates.
What are your suggestions for how you can make improvements
in Leadership?

Innovation

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You solve problems with insight and understanding.
  1. You develop new products and services.
  1. You create a safe environment for idea-sharing.
  1. You find creative ways to get things done with limited resources.
What are your suggestions for how you can make improvements
in Innovation?

Juggling Multiple Responsibilities

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You organize tasks for the most efficient order of completion.
  1. You spend the most time and effort on critical tasks first.
  1. You avoid bottlenecks in progress by assigning multiple individuals to critical tasks.
  1. You observe, analyze, and respond to merchandise needs while serving customers and accomplishing operational tasks.
What are your suggestions for how you can make improvements
in Juggling Multiple Responsibilities?

Clarity

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You clarify problems and their causes to help employees correct them.
  1. You adjust communication methods to the needs of the audience.
  1. You communicate with clarity and efficiency.
  1. You provide a clear vision for the future.
What are your suggestions for how you can make improvements
in Clarity?

Managing Risk

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. I implement strategic risk management in an objective and tactical way.
  1. I take calculated risks by effectively recognizing and managing them.
  1. You communicate the protocols.
  1. You work within constraints of the organization.
What are your suggestions for how you can make improvements
in Managing Risk?

Interpersonal Skills

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. I am transparent and honest in communications, intentions, and actions.
  1. I show appreciation for other's work.
  1. You adapt management style to meet the needs of the individual or situation.
  1. I build strong relationships with team members.
What are your suggestions for how you can make improvements
in Interpersonal Skills?

Responsible

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You take personal responsibility for results.
  1. You set a good example
  1. You set a good example.
  1. You act as a resource without removing individual responsibility.
What are your suggestions for how you can make improvements
in Responsible?

Co-worker Development

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You set and clearly communicate expectations, performance goals, and measurements to others
  1. You give others development opportunities through project assignments and increased job responsibilities
  1. You adapt coaching and mentoring approach to meet the style or needs of individuals
  1. You work to identify root causes of performance problems
What are your suggestions for how you can make improvements
in Co-worker Development?

Global Perspective

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You understand global systems such as the global economy.
  1. You consider customers point of view when making decisions.
  1. You form strong client relationships with international partners.
  1. You volunteer for experiences and assignments abroad.
What are your suggestions for how you can make improvements
in Global Perspective?


  1. Strengths


  2. Areas for Development


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