Emotional Intelligence - 360 Degree Feedback Survey Sample #3





Questionnaires Measuring Emotional Intelligence:
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)
Self-Assessment Instructions

Leadership at [Company] are participating in a 360-Degree Feedback assessment. As part of this process, you need to complete a self-assessment questionnaire form. Other employees, including your manager(s), peers, and direct reports will also evaluate you. In this manner, you will be provided with a comprehensive, multi-perspective (i.e., 360-degree) view of your performance as a manager. The objective is to provide you with feedback so as to allow you to improve your performance, resulting in improved team performance, and organizational effectiveness.

If you are not able to respond to an item, leave it blank and go on to the next item.

Competencies Included:
Emotional Intelligence, Delegation, Decision Making, Commitment To Result, Technical, Continual Improvement, Interpersonal Skills, Client Focus, Negotiation, Recognition, Vision
Sample Result Document:
Sample Results
We encourage everyone to complete the survey. Please be honest, constructive and thoughtful in your input. The survey is designed to help us understand more about your thoughts and needs to make this a great company.

Please ensure that your submission is made between . The survey will only be available during these dates.




Emotional Intelligence

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. You are able to control your own emotions.
  1. You help to make decisions and solve problems using knowledge about how others will react in certain situations.
  1. You help employees to resolve conflicts, communicate clearly, and work together to solve problems.
  1. You accurately perceive the emotional reactions of others.
  1. You are attentive to emotional cues and interprets others' feelings correctly.
Please feel free to provide any comments to help explain your answers?

Delegation

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. You delegate authority and responsibility to subordinates and holds them accountable for your actions.
  1. You define the roles, responsibilities, required actions, and deadlines for team members.
  1. You allow subordinates to use their own methods and procedures.
  1. You assign tasks to create learning opportunities for the employees.
  1. You define goals and objectives for subordinates.
Please feel free to provide any comments to help explain your answers?

Decision Making

Does Not
Exhibit this
Competency
Seldom
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Competency
Sometimes
Exhibits this
Competency
Usually
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Competency
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Competency
  1. You act confidently in the absence of guidance.
  1. You use reasonable assumptions and logic to decide between alternate courses of action
  1. You determine the constraints that may impact what decisions are acceptable.
  1. You learn from previous bad decisions and rarely repeat them.
  1. I view issues from multiple perspectives before making a decision.
Please feel free to provide any comments to help explain your answers?

Commitment To Result

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. You are able to focus on a task even when working alone.
  1. You coordinate all department activities into a cohesive team effort.
  1. You convey strong sense of own pride in Company to associates by creating a shared vision around sales and customer service.
  1. You maintain persistence and dedication to achieving results.
  1. You create a sense of urgency among the store team members to complete activities, which drive sales.
Please feel free to provide any comments to help explain your answers?

Technical

Does Not
Exhibit this
Competency
Seldom
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Competency
Sometimes
Exhibits this
Competency
Usually
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Competency
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Exhibits this
Competency
  1. You demonstrate mastery of the technical competencies required in your work.
  1. You are knowledgeable of procedures or systems necessary for the job.
  1. You are naturally sought out by people outside your particular area for advice and opinion on a broad range of matters - not necessarily solely legal advice.
  1. You willingly share your technical expertise; sought out as resource by others
  1. You seek information from others as needed.
Please feel free to provide any comments to help explain your answers?

Continual Improvement

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
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Competency
Always
Exhibits this
Competency
  1. You search for new methods, techniques, and processes that increase efficiency and reduce costs.
  1. You are open to the suggestions from others.
  1. You look for ways to expand and learn new job skills.
  1. You encourage an employee culture of continuous improvement to seek out better ways of doing things.
  1. You look for ways to improve work processes and procedures.
Please feel free to provide any comments to help explain your answers?

Interpersonal Skills

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
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Competency
Always
Exhibits this
Competency
  1. I pay close attention to what is being communicated verbally and nonverbally.
  1. You demonstrate willingness to work with others.
  1. I consider the other individual's point of view.
  1. You are open and approachable
  1. I promote acceptance of diverse viewpoints from team members.
Please feel free to provide any comments to help explain your answers?

Client Focus

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
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Competency
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Exhibits this
Competency
  1. You maintain strong relationships with clients.
  1. You create innovative solutions to meet client needs.
  1. You follow up with any unanswered questions from the client.
  1. You consistently exceed client expectations.
  1. You build trust with the client.
Please feel free to provide any comments to help explain your answers?

Negotiation

Does Not
Exhibit this
Competency
Seldom
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Competency
Sometimes
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Competency
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Competency
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Competency
  1. You are able to adapt to changing situations.
  1. You change communication styles to meet the listener's needs.
  1. You are able to say "no" when necessary to effectively execute business strategy and meet long-term objectives.
  1. You understand the expectations of other parties in the negotiation.
  1. You stay calm and focus on the core issues to be discussed.
Please feel free to provide any comments to help explain your answers?

Recognition

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. You compliment other people when they do good work
  1. You readily share credit and gives others opportunity for visibility.
  1. You recognize team members who offer a significant contribution to a project.
  1. You are sincerely interested in the suggestions of co-workers
  1. You reinforce and reward employees for accomplishing necessary goals.
Please feel free to provide any comments to help explain your answers?

Vision

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. You lead employees in new directions.
  1. You work to support the strategy of [Company]
  1. You clearly articulate a vision for your work and inspires others to support it
  1. You demonstrate consistency between words and actions
  1. You develop action plans to align your work with the goals of the organization
Please feel free to provide any comments to help explain your answers?

  1. Overall, please rate the effectiveness of [Participant Name].






  2. Strengths


  3. Areas for Development


  4. Please give any final comments or suggestions for [Participant Name Here]'s assessment.