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
Is able to manage their own emotions.
Able to understand others' points of view.
Helps employees to resolve conflicts, communicate clearly, and work together to solve problems.
Is able to control their own emotions.
Accurately perceives the emotional reactions of others.
Performance	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Sets a high standard for job performance.
Effectively organizes resources and plans
Works effectively in the department.
Effective in performing his/her job.
Works well in this position.
Adaptability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Responds quickly to new information.
Continually trying to improve skills to remain current.
Is aware of changes to team personnel.
Is flexible and open minded in dealing with others.
Works effectively in dynamic and changing work environments.
Bias for Action	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Displays high energy and enthusiasm on consistent basis.
Identifies ways to simplify work processes and reduce cycle times
Completes a large volume of work.
Encourages risk taking and experimentation to improve performance
Projects a "can-do" attitude when interfacing with peers, subordinates and customers(especially during difficult and challenging times).
Problem Solving	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Effective in solving problems.
Actively seeks the root cause of a problem.
Makes judgments based upon relevant information.
Implements effective solutions to critical problems.
Understands the root causes of problems.
Initiative	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Takes advantage of opportunities when they become available.
Initiates draft reports for consideration.
Initiates actions that impact the department/company.
Takes action without being asked.
Anticipates problems and initiates plans to address them.
Results Oriented	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Plans the best course of action to achieve the goal.
Encourages a high-energy, fun work environment and coaches others on how to do the same
Is a high achiever.
Has a strong result orientation.
Measures progress toward the goal.
Teamwork	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Makes decisions that support the team's goals and objectives.
Creates opportunities to learn with other team members
Encourages others to share ideas to develop team cohesion
Identifies and resolves conflicts within the team to increase team effectiveness
Focuses on understanding the other team member's message.

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: