Communication - 360 Degree Feedback Survey Sample #2





Questionnaires Measuring Communication:
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:
Communication Skills, Continual Improvement, Attitude, Analytical, Juggling Multiple Responsibilities, Collaboration, Trustworthy, Vision
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.


Communication Skills

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You are listening to both sides in employer/employee disputes
  1. You communicate effectively with colleagues.
  1. I articulate ideas clearly and assertively.
  1. You are persuasive and articulate when communicating.
  1. You ask follow-up questions as needed.
What are your suggestions for how you can make improvements
in Communication Skills?

Continual Improvement

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You search for new methods, techniques, and processes that increase efficiency and reduce costs.
  1. You pursue efforts to improve by seeking feedback from others.
  1. You evaluate the effectiveness of improvements.
  1. You are open to the suggestions from others.
  1. You look for ways to expand and learn new job skills.
What are your suggestions for how you can make improvements
in Continual Improvement?

Attitude

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You contribute to a positive and fun work environment.
  1. You are able to cope with changes
  1. You are gracious and professional in your interactions with others.
  1. You treat all people fairly and with respect.
  1. You work to eliminate unnecessary work or barriers that get in others' way.
What are your suggestions for how you can make improvements
in Attitude?

Analytical

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You analyze issues and reduce them to their component parts.
  1. You prioritize various actions to be taken when solving a problem.
  1. You use standard data collection practices.
  1. You identify deviations from stated goals and objectives.
  1. You use alternate tools for analysis to check the reliability of previous analyses.
What are your suggestions for how you can make improvements
in Analytical?

Juggling Multiple Responsibilities

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You delegate tasks to others when needed.
  1. You begin tasks as soon as possible.
  1. You use software scheduler to keep track of projects.
  1. You plan and organize continuously while performing all other responsibilities and activities.
  1. You can easily switch between tasks when a critical incident requires attention.
What are your suggestions for how you can make improvements
in Juggling Multiple Responsibilities?

Collaboration

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You place value on the views of others in decision making.
  1. You readily share information with other group members.
  1. You encourage collaboration with other departments.
  1. You create an environment that encourages information sharing.
  1. You identify and prioritize needs based on shared interests.
What are your suggestions for how you can make improvements
in Collaboration?

Trustworthy

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You deliver on promises made.
  1. You are a person others can count on.
  1. You communicate an understanding of the other person's interests, needs and concerns.
  1. You seek to mitigate grievances by clarifying intentions and finding suitable remedies.
  1. You demonstrate a sense of responsibility and commitment to public trust.
What are your suggestions for how you can make improvements
in Trustworthy?

Vision

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You express the Company vision in a way that is easily understood and adopted by employees.
  1. You clearly articulate a vision for your work and inspires others to support it
  1. You create a common vision for others.
  1. You work to support the strategy of [Company]
  1. You create a positive vision of the future for the Company.
What are your suggestions for how you can make improvements
in Vision?


  1. Strengths


  2. Areas for Development


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