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
Able to understand others' points of view.
Helps employees to resolve conflicts, communicate clearly, and work together to solve problems.
Is attentive to emotional cues and interprets others' feelings correctly.
Is able to control their own emotions.
Is able to express themselves clearly.
Performance	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
...Overall Performance
...Produce Quality
Works well in this position.
Shown significant improvement in job performance.
Sets a high standard for job performance.
Adaptability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Able to step in and help co-workers when needed.
Responsive to the needs of others.
Accommodates changes as needed.
Able to work effectively with new people and new teams.
Adjusts tactics and strategies.
Bias for Action	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Seeks and utilizes opportunities for continuous learning and self-development.
Completes work on time
Identifies ways to simplify work processes and reduce cycle times
Encourages risk taking and experimentation to improve performance
Completes a large volume of work.
Problem Solving	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Works cooperatively with others to solve problems.
Makes judgments based upon relevant information.
Identifies and assesses all potential responses to a problem.
Effective in solving problems.
Generates alternative solutions to problems and challenges.
Initiative	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is a self-starter. Does not wait to be told to do something.
Actively works on resolving the issue instead of procrastinating or hoping it will resolve itself.
Acts quickly when an opportunity becomes available.
Inspires others to perform above expectations.
Takes action to establish clear and concise deadlines for tasks to be completed.
Results Oriented	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Holds self and others accountable for achieving results.
Prioritizes goals to complete those in urgent need first.
Quickly analyzes the situation to determine the most pressing needs.
Helps the team maintain focus on the goals.
Promptly and efficiently completes assigned tasks.
Teamwork	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Builds strong relationships with team members.
Encourages other team members to adopt new procedures.
Provides assistance and support to other team members when needed
Willing to listen to the ideas of other team members.
Coaches team members to work toward a common goal.

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: