Emotional Intelligence - 360 Degree Feedback Survey Sample #4

Dear Employee:


Welcome to our 360-Degree Feedback Assessment of [Participant Name]. Our objective is to provide feedback which will help advance his/her leadership skills and capabilities. We are asking you to take time to respond to this survey to help us identify where we are doing well and where we have opportunities to do better.

We have developed this survey with questions tailored for [Participant Name]'s position in the department to provide you with an opportunity to anonymously rate many facets of his/her leadership performance. The survey will assess what you value most in their leadership skills and allow you to make positive suggestions for improvement.

Please be honest, constructive and thoughtful in your responses. The results of this survey will be used to help drive our future success. If you have any questions about the process please contact [Contact Person].

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

Thank you for your participation in the survey. We look forward to seeing the analysis of your responses and we are hoping for 100% participation.

Management Team

Instructions:
Please complete the items below and press the submit button at the end of the survey. If you need multiple sessions to complete the survey, please click the "Submit" button at the end of each session to save your responses. Please feel free to skip any items that you do not wish to respond to. Keep in mind that your responses help us to become a better place to work. So, you are encouraged to respond to all items on the questionnaire.

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Emotional Intelligence	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Helps employees to resolve conflicts, communicate clearly, and work together to solve problems.
Is able to control their own emotions.
Is attentive to emotional cues and interprets others' feelings correctly.
Able to understand others' points of view.
Helps to make decisions and solve problems using knowledge about how others will react in certain situations.
Performance	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Has great overall performance
Sets a high standard for job performance.
Able to organize work.
Works effectively in the department.
...Produce Quality
Adaptability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is proactive and takes steps to prepare for changes in the workplace.
Flexible and open to new ideas and encourages others to value change.
Develops insights and applies innovative solutions to projects and problems.
Works effectively in dynamic and changing work environments.
Ability to recognize the potential benefits of change, and create an infrastructure which supports change.
Bias for Action	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Completes a large volume of work.
Seeks and utilizes opportunities for continuous learning and self-development.
Coach others to foster an environment which can adapt quickly and willingly to rapid change.
Encourages risk taking and experimentation to improve performance
Motivates others to achieve or exceed goals
Problem Solving	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Ability to solve problems at root cause rather than at symptom level.
Able to balance the needs of different people in a solution to a problem.
Is a good problem solver and decision maker
Solves problems using logic and insight.
Effective in solving problems.
Initiative	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Coach others to foster an environment which can adapt quickly and willingly to rapid change.
Goes above and beyond the stated goals.
Takes decisive action to address problems, following up with relevant team members and coaching them on how to improve.
Seeks and utilizes opportunities for continuous learning and self-development.
Prepares for unexpected contingencies.
Results Oriented	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Encourages a high-energy, fun work environment and coaches others on how to do the same
Demonstrates the personal confidence to "stay the course," even when faced with difficulty
Works toward achievement of goals even when confronted with obstacles.
Inspires and motivates co-workers to be productive and energetic at work
Stays focused on meeting the needs of customers.
Teamwork	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Encourages open communication
Actively and openly participates in group meetings.
Works cooperatively with others to solve problems.
Carries his/her share of the workload
Provides assistance and support to other team members when needed

41. On a scale of Excellent to Poor, how would you rate your overall employment with [Company] and why?
    

    -Excellent -Good -Average -Poor




42. Would you refer others who are seeking employment to [Company]?
    Yes No
    
    Please provide explanation:
    
    


43. If you had an opportunity to make any change you wanted to make [Company] a better place to work, what one improvement would you make?
    
    
    


44. What changes do you see [Company] making in order to raise the standards?
    
    


45. I feel good about my continued employment with [Company].
    Yes No
    
    If no, please provide explanation:
    
    
    


46. What do you like best about working for [Company]?
    
    


47. What do you like least about working for [Company]? How could it be improved?
    


93. Use the space below to enter any final comments you would like to be noted: