Coworker Development- 360 Degree Feedback Survey Sample #8

Questionnaires Measuring Coworker Development:
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 .

Co-worker Development

Agree Unsure Disagree N/A
  1. Adapts coaching and mentoring approach to meet the style or needs of individuals
  1. Sets and clearly communicates expectations, performance goals, and measurements to others
  1. Works to identify root causes of performance problems
  1. Takes immediate action on poor performance
  1. Gives others development opportunities through project assignments and increased job responsibilities

Professional Development

Agree Unsure Disagree N/A
  1. Demonstrate enthusiasm and a willingness to learn new skills and knowledge
  1. Contributing fully to the extent of their skills
  1. Quickly acquire and apply new knowledge and skills when needed
  1. Allows employees to fully participate in employee training and professional development.
  1. Seeks opportunities for professional development.

Self Management

Agree Unsure Disagree N/A
  1. Deals with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
  1. Analyzes interpersonal problems instead of reacting to them.
  1. Sets an example for associates during stressful periods by maintaining a positive, can-do attitude.
  1. Uses patience and self-control in working with customers and associates.
  1. Does not allow own emotions to interfere with the performance of others.

Emotional Intelligence

Agree Unsure Disagree N/A
  1. Is able to control their own emotions.
  1. Is able to express themselves clearly.
  1. Is able to manage their own emotions.
  1. Is attentive to emotional cues and interprets others' feelings correctly.
  1. Helps employees to resolve conflicts, communicate clearly, and work together to solve problems.

Persuasion and Influence

Agree Unsure Disagree N/A
  1. Develops a good rapport with others.
  1. Communicates effectively with others.
  1. Has excellent influencing/negotiating skills.
  1. Ensures stakeholders are involved in the decision making process.
  1. Persuades others to consider alternative points of view.


Agree Unsure Disagree N/A
  1. Entrusts subordinates with important tasks.
  1. Delegates authority and responsibility to subordinates and holds them accountable for their actions.
  1. Defines the roles, responsibilities, required actions, and deadlines for team members.
  1. Sets clear and reasonable expectations for others and follows through on their progress.
  1. Defines goals and objectives for subordinates.


Agree Unsure Disagree N/A
  1. Is creative.
  1. Conceives, implements and evaluates ideas.
  1. Develops solutions to challenging problems.
  1. Adds value to the department/organization.
  1. Is creative and inspirational.


Agree Unsure Disagree N/A
  1. Schedules time for self and others to optimize high priority and long term actions. Monitors progress towards business goals.
  1. Holds others to high standards of achievement.
  1. Helps others to improve or meet standards of performance.
  1. Allocates resources as needed to accomplish organizational goals.
  1. Eliminates bureaucratic barriers to streamline processes.


Agree Unsure Disagree N/A
  1. Assures [Company] principles are understood, employed & pursued.
  1. Consistently provides me with timely feedback for improving my performance.
  1. Effectively organizes resources and plans
  1. Ability to establish realistic goals.
  1. Sets long-term and short-term goals.

Customer Focus

Agree Unsure Disagree N/A
  1. Consistently models positive customer service attitudes.
  1. Takes the initiative in solving difficult customer issues.
  1. Promotes, implements, maintains and enhances relationships with customers.
  1. Persistent in solving customer issues.
  1. Builds products that meet the unique needs of each customer.

Fiscal Management

Agree Unsure Disagree N/A
  1. Ensures others follow the correct rules and regulations on fiscal matters.
  1. Monitors expenses and verifies the need for items purchased.
  1. Develops budgets and plans for various programs and initiatives.
  1. Monitors spending.
  1. Effective in using Company's resources.

  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.