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Communication - 360 Degree Feedback Survey Sample #5





360-Degree Assessment Survey

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

Thank you for providing feedback for the recipient above. As you respond, please draw on your first-hand experience with this individual in the past 12 months. Rate each item using the scale shown. If you don't feel you have enough first-hand information to rate a certain item, please choose the Not Applicable option. Comments can be very helpful; at a minimum where you give a particularly high or low rating, please share your reasons in the Closing Comments section. Your responses will be compiled with feedback from others and presented to the recipient to help guide their ongoing development.

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 by .

Thank you for your participation in the survey.

Management Team



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Communication Skills

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Comes across as comfortable and effective as a public speaker
  1. Checks for understanding throughout conversations or group presentations/discussions
  1. Discusses ideas and concepts with peers.
  1. Is willing to give feedback to others even if that feedback is critical of their approach.
  1. Has the confidence to communicate effectively to all levels (from CEO down) of the organization, external customers, suppliers, as well as the senior counsel of other companies.


Passion To Learn

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Holds self and associates accountable for goal achievement.
  1. Embraces new technology and procedures.
  1. Enjoys learning new skills and techniques.
  1. Takes initiative for own learning and development.
  1. Will participate in training classes even if offered outside of normal working hours.


Continual Improvement

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Encourages an employee culture of continuous improvement to seek out better ways of doing things.
  1. Open to the suggestions from others.
  1. Looks for ways to expand current job responsibilities.
  1. Looks for ways to expand and learn new job skills.
  1. Searches for new methods, techniques, and processes that increase efficiency and reduce costs.


Establishing Focus/Direction

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Aligns the department's goals with the goals of the organization.
  1. Makes sure that employees understand how their work relates to organizational goals.
  1. Helps guide employees with prioritizing tasks.
  1. Sets appropriate goals for employees.
  1. Maintains focus when handling several problems or tasks simultaneously.


Persuasion and Influence

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Persuades others to consider alternative points of view.
  1. Seeks to obtain consensus or compromise.
  1. Communicates effectively with others.
  1. Ensures stakeholders are involved in the decision making process.
  1. Understanding what others need.


Delegation

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Sets clear and reasonable expectations for others and follows through on their progress.
  1. Tells subordinates what to do, not how to do it.
  1. Allows subordinates to use their own methods and procedures.
  1. Defines goals and objectives for subordinates.
  1. Assigns tasks to create learning opportunities for the employees.


Administrative Skill

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Strong organizational skills to keep the workspace and department in order
  1. Enthusiastic about taking on challenging projects.
  1. Accurately implements contract provisions.
  1. Completes reports on-time.
  1. Implements and uses performance measures.


Excellence

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Takes a lot of pride in their work.
  1. Produces high quality work.
  1. Can be counted on to add value wherever they are involved.
  1. Is planful and organized.
  1. Keeps themselves and others focused on constant improvement.


Developing Others

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Tries to ensure employees are ready to move to the next level.
  1. Supports the successes of other employees.
  1. Recognizes and celebrates accomplishments of others.
  1. Creates a work environment that fosters positive feedback to employees.
  1. Encourages employees through recognition of positive changes in behavior.


Coaching

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Conducts regular performance appraisals and feedback.
  1. Provides clear, motivating, and constructive feedback.
  1. Addresses employee behavior problems effectively.
  1. Coaches employees in how to strengthen knowledge and skills to improve work performance.
  1. Helps employees to understand responsibilities, authority, and expectations.


Partnering/Networking

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Is comfortable working in partnership with colleagues from other departments.
  1. Maintains communication channels with colleagues in the industry.
  1. Participates in conflict resolution to find mutually beneficial solutions.
  1. Creates the conditions for partnerships to grow and develop.
  1. Develops important industry contacts to facilitate business goals.


Planning

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Analyzes market trends to plan the best course of action.
  1. Is able to clearly articulate the plan for the department/district.
  1. Accurately estimates the duration of tasks.
  1. Schedules staff based on seasonal needs.
  1. Creates to-do lists to make sure nothing is missed.



  1. Overall, please rate the effectiveness of [Participant Name Here].






  2. Strengths


  3. Areas for Development


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