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 manage their own emotions.
Able to understand others' points of view.
Is able to express themselves clearly.
Is able to control their own emotions.
Performance	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Listens and responds to issues and problems
...Overall Performance
...Produce Quality
Works effectively in the department.
Shown significant improvement in job performance.
Adaptability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Handles unexpected events without a loss of productivity.
Responds quickly to new information.
Adjusts strategy when new information is presented.
Embraces change and fosters an open-minded environment.
Handles changes easily.
Bias for Action	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Completes a large volume of work.
Motivates others to achieve or exceed goals
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.
Displays high energy and enthusiasm on consistent basis.
Problem Solving	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Actively seeks the root cause of a problem.
Makes judgments based upon relevant information.
Effective in solving problems.
Solves problems using logic and insight.
Identifies and assesses all potential responses to a problem.
Initiative	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Takes advantage of opportunities when they become available.
Immediately informs the HR Department of any personnel complaints or issues.
Prepares for unexpected contingencies.
Seizes upon opportunities available.
Takes corrective action to address performance deficiencies/issues.
Results Oriented	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Removes bureaucratic barriers to streamline processes.
Works hard despite obstacles that impede progress.
Determines the objectives for the project.
Willing to adapt to new procedures to maintain production capacities.
Prioritizes goals to complete those in urgent need first.
Teamwork	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Takes the time to actively listen to other team member's perspectives.
Considers the impact and implications of decisions on the team.
Works with other team members to achieve objectives.
Listens carefully to other team members.
Encourages dialog between team members.

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: