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. Presents issues, ideas, and strategy concisely and clearly.
  1. Delivers information in a clear, concise, and logical manner.
  1. Addresses issues of key importance to stakeholders.
  1. Asks follow-up questions as needed.
  1. Able to deliver presentations.

Self Management

Agree Unsure Disagree N/A
  1. Is aware of personal impact on others and adjusts behavior to create a positive leadership presence.
  1. Sets an example for associates during stressful periods by maintaining a positive, can-do attitude.
  1. Analyzes own reactions on the spot to ensure that communication does not appear to be driven by anger.
  1. Steps away from a situation to process appropriate response.
  1. Uses patience and self-control in working with customers and associates.

Passion To Learn

Agree Unsure Disagree N/A
  1. Recognizes own areas for development and consciously seeks assignments that will provide practice in areas of developmental need.
  1. Takes advantage of training opportunities when they arise.
  1. Exhibits willingness to upgrade skills through additional training and education.
  1. Is committed to enhancing their own knowledge and skills.
  1. Is open minded and curious about learning new skills.


Agree Unsure Disagree N/A
  1. Seeks feedback to enhance performance.
  1. Shares past experiences with others as learning opportunities.
  1. Considers other's opinion and suggestions.
  1. Actively seeks feedback from others.
  1. Accepts the views of others.

Time Management

Agree Unsure Disagree N/A
  1. Completes high-priority work within required timelines.
  1. Focuses on tasks that have high priority.
  1. Leaves time in the schedule for unplanned contingencies.
  1. Prioritizes new tasks according to their relative importance.
  1. Sets a good balance between work and family life.


Agree Unsure Disagree N/A
  1. Consistently keeps commitments.
  1. Demonstrates congruence between statements and actions.
  1. Delivers on promises made.
  1. Seeks to mitigate grievances by clarifying intentions and finding suitable remedies.
  1. Demonstrates a sense of responsibility and commitment to public trust.


Agree Unsure Disagree N/A
  1. Respects the opinions of other employees.
  1. Forms working relationships with employees from other departments.
  1. Works effectively with people from other departments.
  1. Able to see issues from others' perspectives.
  1. Supports the efforts of other employees in implementing solutions to problems.

Strategic Focus

Agree Unsure Disagree N/A
  1. Able to decline a poor strategy by proposing alternate strategies.
  1. Sustains or achieves a competitive advantage for the organization by analyzing the best practices and lessons learned from other organizations.
  1. Focuses attention on treating the causes of problems rather than simply addressing the symptoms.
  1. Looks for opportunities to enhance contributions to the bottom line.
  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. Impresses upon others the important aspects of [Company].
  1. Follows existing procedures and processes.
  1. Attends [Company] gatherings and social events.
  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. Creates an environment where individual differences are valued and supported.
  1. Demonstrates a curiosity about diverse individuals and cultures.
  1. Exemplifies the skills of a global worker.
  1. Engages in problem solving with individuals outside of the country.

  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.