Communication - 360 Degree Feedback Survey Sample #8

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)

You have been selected to provide feedback for the manager listed above. Your feedback is an important part of 's leadership development process. This tool 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 assessment form, please think about your experiences working with this individual during the last six to twelve months. Your responses will be merged with other people's feedback and presented to to guide them in their on-going development. Comments will be shared anonymously, as written, with the manager.

Sample Result Document:
Sample Results
Method of use: As part of the review process, managers will receive feedback from peers and staff. It is recognized that not all participants will be able to assess an individual's performance in all areas. The feedback received will be utilized as input to the manager's performance and on-going development plan.

You may sign out at any time by pressing the Save button at the end of the form and then closing your browser. You may return later to pick up where you left off. When you are done, press the Complete button.

When clicking your selection below, try to best fit the manager's actual behaviors to the scale provided.

If you are not sure, or unable to assess, select "Not Applicable" (N/A) option.

Please complete your response by .

Communication Skills

Agree Unsure Disagree N/A
  1. Gives clear and convincing presentations.
  1. Deals with difficult situations calmly and confidently.
  1. Delivers influential presentations.
  1. Delivers information in a clear, concise, and logical manner.
  1. Able to deliver presentations.

Self Management

Agree Unsure Disagree N/A
  1. Consciously controls own negative emotions in order to keep team morale up.
  1. Analyzes interpersonal problems instead of reacting to them.
  1. Steps away from a situation to process appropriate response.
  1. Does not allow own emotions to interfere with the performance of others.
  1. Analyzes own reactions on the spot to ensure that communication does not appear to be driven by anger.

Passion To Learn

Agree Unsure Disagree N/A
  1. Is committed to enhancing their own knowledge and skills.
  1. Creates an environment that supports personal development and exploration.
  1. Demonstrates a willingness to participate in continuing education courses.
  1. Is open minded and curious about learning new skills.
  1. Will participate in training classes even if offered outside of normal working hours.


Agree Unsure Disagree N/A
  1. Open to the suggestions of others.
  1. Shares past experiences with others as learning opportunities.
  1. Seeks feedback to enhance performance.
  1. Is visible and approachable.
  1. Looks to others for input.

Time Management

Agree Unsure Disagree N/A
  1. Completes tasks ahead of schedule.
  1. Prioritizes new tasks according to their relative importance.
  1. Deals effectively with interruptions.
  1. Keeps and maintains a To-Do list.
  1. Makes time for developing plans and schedules.


Agree Unsure Disagree N/A
  1. Communicates an understanding of the other person's interests, needs and concerns.
  1. Demonstrates a sense of responsibility and commitment to public trust.
  1. Builds and maintains the trust of others.
  1. Is a person you can trust.
  1. Demonstrates congruence between statements and actions.


Agree Unsure Disagree N/A
  1. Consistently demonstrates ability and willingness to trust others.
  1. Treats others with respect and dignity.
  1. Forms working relationships with employees from other departments.
  1. Is able to see issues from others' perspectives.
  1. Works across boundaries within the organization.

Strategic Focus

Agree Unsure Disagree N/A
  1. Sustains or achieves a competitive advantage for the organization by analyzing the best practices and lessons learned from other organizations.
  1. Creates plans to develop and promote organizational and area strengths, as well as to address weaknesses.
  1. Able to decline a poor strategy by proposing alternate strategies.
  1. Communicates goals and objectives to employees.
  1. Monitors performance of each market within the Area, utilizing reports to ensure sales growth, cost management, and profitability targets are met.


Agree Unsure Disagree N/A
  1. Attends [Company] gatherings and social events.
  1. Follows existing procedures and processes.
  1. Impresses upon others the important aspects of [Company].
  1. Understands the use of [Company] products and services.
  1. Understands how decisions impact other business units beyond their immediate department of work group.

Global Perspective

Agree Unsure Disagree N/A
  1. Sets the example for team on importance of cultural awareness.
  1. Develops both the cultural awareness and business skills to grow our business in all countries, and work effectively across borders with employees, customers, and shareowners.
  1. Demonstrates a curiosity about diverse individuals and cultures.
  1. Comfortable using teleconferencing equipment to facilitate meetings with others abroad.
  1. Understands how cultures differ and how these differences impact work behavior.

  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.