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)
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 .


Agree Unsure Disagree N/A
  1. Allows employees to decide how they wish to complete the tasks.
  1. Assigns tasks to create learning opportunities for the employees.
  1. Defines the roles, responsibilities, required actions, and deadlines for team members.
  1. Allows subordinates to use their own methods and procedures.
  1. Clearly defines duties and tasks to be completed.

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. Uses agendas when chairing or facilitating meetings.
  1. Makes time for developing plans and schedules.
  1. Sets clearly defined goals.


Agree Unsure Disagree N/A
  1. Consistently provides me with timely feedback for improving my performance.
  1. Sets long-term and short-term goals.
  1. Assures [Company] principles are understood, employed & pursued.
  1. Able to organize work.
  1. Works toward achieving established goals and objectives.


Agree Unsure Disagree N/A
  1. Works effectively during periods of change.
  1. Open to the perspectives/viewpoints of others.
  1. Willing to try new ideas.
  1. Implements changes as a result of having listened to employees
  1. Able to adapt to new situations.

Bias for Action

Agree Unsure Disagree N/A
  1. Completes work on time
  1. Motivates others to achieve or exceed goals
  1. Completes a large volume of work.
  1. Projects a "can-do" attitude when interfacing with peers, subordinates and customers(especially during difficult and challenging times).
  1. Coach others to foster an environment which can adapt quickly and willingly to rapid change.

Continual Learning

Agree Unsure Disagree N/A
  1. Improves on their skill sets.
  1. Pursues self-improvement through continual learning.
  1. Pursues professional development opportunities when they arise.
  1. Sets relevant learning objectives and goals.
  1. Takes charge of their training and skills enhancement.


Agree Unsure Disagree N/A
  1. Accepts the views of others.
  1. Open to the suggestions of others.
  1. Is easy to approach with ideas and opinions.
  1. Seeks feedback to enhance performance.
  1. Asks others for their ideas and opinions.

Client Focus

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

Customer Focus

Agree Unsure Disagree N/A
  1. ...friendliness and courtesy
  1. Asks questions and listens carefully to determine customer needs and to ensure that the customer's needs are met.
  1. Considers customers point of view when making decisions.
  1. Does not hesitate to address customer concerns or complaints.
  1. Develops good rapport and trust with the customer.


Agree Unsure Disagree N/A
  1. Forges mutually beneficial relationships between individuals with diverse backgrounds.
  1. Seeks an understanding of diverse functions within the Company.
  1. Maintains infrastructure to support partnerships and networks.
  1. Creates value within the Company by building networks.
  1. Seeks to reduce institutional roadblocks to information sharing.

  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.