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. Defines goals and objectives for subordinates.
  1. Entrusts subordinates with important tasks.
  1. Delegates tasks, responsibilities, and accountability as appropriate to the level of employee.
  1. Sets clear and reasonable expectations for others and follows through on their progress.
  1. Allows employees to decide how they wish to complete the tasks.

Time Management

Agree Unsure Disagree N/A
  1. Completes tasks ahead of schedule.
  1. Avoids distractions in the workplace.
  1. Sets clearly defined goals.
  1. Does not procrastinate.
  1. Makes time for developing plans and schedules.


Agree Unsure Disagree N/A
  1. Effectively organizes resources and plans
  1. Able to organize work.
  1. Organizes and schedules events, activities, and resources.
  1. Establishes goals and objectives.
  1. Sets long-term and short-term goals.


Agree Unsure Disagree N/A
  1. Encourages others to adopt new procedures.
  1. Able to adapt to new situations.
  1. Identifies new opportunities to achieve goals
  1. Adapts to circumstances as needed.
  1. Adapts to new organizational structures, policies, or procedures.

Bias for Action

Agree Unsure Disagree N/A
  1. Completes work on time
  1. Seeks and utilizes opportunities for continuous learning and self-development.
  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. Is open to new ideas and concepts.
  1. Pursues self-improvement through continual learning.
  1. Seeks opportunities to grow in skills and knowledge.
  1. Improves on their skill sets.
  1. Pursues learning that will enhance job performance.


Agree Unsure Disagree N/A
  1. Seeks feedback to enhance performance.
  1. Considers other's opinion and suggestions.
  1. Looks to others for input.
  1. Open to the suggestions of others.
  1. Is easy to approach with ideas and opinions.

Client Focus

Agree Unsure Disagree N/A
  1. Exceeds expectations of the clients.
  1. Creates documents that meet the client's specifications.
  1. Demonstrates a commitment to client focus.
  1. Supports client focused policies and procedures.
  1. Obtains feedback to ensure client needs are being met.

Customer Focus

Agree Unsure Disagree N/A
  1. Persistent in solving customer issues.
  1. Provides excellent service to customers.
  1. Puts customer's needs first.
  1. Helps customers feel they are receiving services tailored specifically to their needs.
  1. Prioritizes the needs and preferences of the customer.


Agree Unsure Disagree N/A
  1. Creates value within the Company by building networks.
  1. Collaborates with others to accomplish goals and objectives.
  1. Seeks to reduce institutional roadblocks to information sharing.
  1. Supports a partnering/networking culture.
  1. Maintains infrastructure to support partnerships and networks.

  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.