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)

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.

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. An effective listener who is responsive to information needs.
  1. Coaches others and provides feedback on the use of different oral communication styles for different audiences
  1. Addresses issues of key importance to stakeholders.
  1. Deals with difficult situations calmly and confidently.
  1. Able to deliver presentations.

Self Management

Agree Unsure Disagree N/A
  1. Sets an example for associates during stressful periods by maintaining a positive, can-do attitude.
  1. Analyzes interpersonal problems instead of reacting to them.
  1. Deals with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
  1. Is aware of personal impact on others and adjusts behavior to create a positive leadership presence.
  1. Does not allow own emotions to interfere with the performance of others.

Passion To Learn

Agree Unsure Disagree N/A
  1. Constantly enhances product knowledge through experimentation and play.
  1. Is motivated by the desire to be "the best".
  1. Persists until goals are achieved and commitments are met.
  1. Critiques own performance and learns from experience as a source of continuous improvement.
  1. Recognizes own areas for development and consciously seeks assignments that will provide practice in areas of developmental need.


Agree Unsure Disagree N/A
  1. Considers other's opinion and suggestions.
  1. Shares past experiences with others as learning opportunities.
  1. Accepts the views of others.
  1. Is visible and approachable.
  1. Looks to others for input.

Time Management

Agree Unsure Disagree N/A
  1. Prioritizes tasks to identify immediate and long-term objectives.
  1. Leaves time in the schedule for unplanned contingencies.
  1. Avoids distractions in the workplace.
  1. Deals effectively with interruptions.
  1. Keeps and maintains a To-Do list.


Agree Unsure Disagree N/A
  1. Seeks to mitigate grievances by clarifying intentions and finding suitable remedies.
  1. Delivers on promises made.
  1. Communicates an understanding of the other person's interests, needs and concerns.
  1. Takes care to maintain confidential information.
  1. Works in a way that makes others want to work with her/him.


Agree Unsure Disagree N/A
  1. Forms working relationships with employees from other departments.
  1. Helpful
  1. Respects the opinions of other employees.
  1. ...treats others with respect and dignity.
  1. Works effectively with people from other departments.

Strategic Focus

Agree Unsure Disagree N/A
  1. Creates plans to develop and promote organizational and area strengths, as well as to address weaknesses.
  1. Understands their role within the organization.
  1. Monitors performance of each market within the Area, utilizing reports to ensure sales growth, cost management, and profitability targets are met.
  1. Looks for opportunities to enhance contributions to the bottom line.
  1. Sustains or achieves a competitive advantage for the organization by analyzing the best practices and lessons learned from other organizations.


Agree Unsure Disagree N/A
  1. Understands how decisions impact other business units beyond their immediate department of work group.
  1. Understands the "basics" as to how [Company] functions/operates.
  1. Expresses loyalty and dedication to [Company] in interactions with others.
  1. Attends [Company] gatherings and social events.
  1. Impresses upon others the important aspects of [Company].

Global Perspective

Agree Unsure Disagree N/A
  1. Considers customers point of view when making decisions.
  1. Understands how cultures differ and how these differences impact work behavior.
  1. Demonstrates working knowledge of global transactions.
  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. Can effectively deliver presentations to international clients.

  1. Overall, please rate the effectiveness of .

  2. Strengths

  3. Areas for Development

  4. Please give any final comments or suggestions for 's assessment.