Delegation - 360 Degree Feedback Survey Sample #8

Questionnaires Measuring Delegation:
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 .


Agree Unsure Disagree N/A
  1. Encourages and empowers subordinates to use initiative in achieving goals and objectives.
  1. Tells subordinates what to do, not how to do it.
  1. Defines the roles, responsibilities, required actions, and deadlines for team members.
  1. Allows subordinates to use their own methods and procedures.
  1. Delegates tasks, responsibilities, and accountability as appropriate to the level of employee.

Time Management

Agree Unsure Disagree N/A
  1. Makes time for developing plans and schedules.
  1. Does not become flustered by deadlines and timelines.
  1. Prioritizes tasks to identify immediate and long-term objectives.
  1. Avoids distractions in the workplace.
  1. Keeps and maintains a To-Do list.


Agree Unsure Disagree N/A
  1. Sets long-term and short-term goals.
  1. Able to organize work.
  1. Ability to establish realistic goals.
  1. Consistently provides me with timely feedback for improving my performance.
  1. Works toward achieving established goals and objectives.


Agree Unsure Disagree N/A
  1. Willing to try new ideas.
  1. Effective in incorporating new ideas.
  1. Adapts to new organizational structures, policies, or procedures.
  1. Can handle changes without complaining.
  1. Adapts to circumstances as needed.

Bias for Action

Agree Unsure Disagree N/A
  1. Completes work on time
  1. Displays high energy and enthusiasm on consistent basis.
  1. Projects a "can-do" attitude when interfacing with peers, subordinates and customers(especially during difficult and challenging times).
  1. Motivates others to achieve or exceed goals
  1. Completes a large volume of work.

Continual Learning

Agree Unsure Disagree N/A
  1. Builds on their strengths while addressing their weaknesses.
  1. Sets relevant learning objectives and goals.
  1. Pursues self-improvement through continual learning.
  1. Shares best practices with others and learns from others.
  1. Grasps new ideas, concepts, technical, or business knowledge.


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

Client Focus

Agree Unsure Disagree N/A
  1. Ensures client commitments and requirements are met or exceeded
  1. Forms strong client relationships
  1. Looks for opportunities that have a positive impact on Clients.
  1. Is pro-active in dealing with clients and addressing their needs.
  1. Satisfies client needs.

Customer Focus

Agree Unsure Disagree N/A
  1. Maintains positive customer relationships.
  1. Ensures all customer commitments and requirements are met or exceeded.
  1. Develops good rapport and trust with the customer.
  1. Asks questions and listens carefully to determine customer needs and to ensure that the customer's needs are met.
  1. Does not hesitate to address customer concerns or complaints.


Agree Unsure Disagree N/A
  1. Capitalizes on partnerships and networks to enhance the Company's bottom line.
  1. Collaborates with others to accomplish goals and objectives.
  1. Seeks an understanding of diverse functions within the Company.
  1. Creates value within the Company by building networks.
  1. Builds alliances between departments and teams.

  1. Overall, please rate the effectiveness of .

  2. Strengths

  3. Areas for Development

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