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Emotional Intelligence - 360 Degree Feedback Survey Sample #5


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)
Dear Employee:

Thank you for providing feedback for the recipient above. As you respond, please draw on your first-hand experience with this individual in the past 12 months. Rate each item using the scale shown. If you don't feel you have enough first-hand information to rate a certain item, please choose the Not Applicable option. Comments can be very helpful; at a minimum where you give a particularly high or low rating, please share your reasons in the Closing Comments section. Your responses will be compiled with feedback from others and presented to the recipient to help guide their ongoing development.

Partially completed forms can be saved by using the Save/Still Working button at the bottom of the page. You may return at a later time to complete/edit the form. Your saved responses will be shown each time you re-visit the feedback form. When you are certain that you have completed your responses and will be not making any changes, click the Complete button.

Please ensure that your submission is made by .

Thank you for your participation in the survey.

Management Team



Emotional Intelligence

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Is able to control their own emotions.
  1. Able to understand others' points of view.
  1. Helps to make decisions and solve problems using knowledge about how others will react in certain situations.
  1. Helps employees to resolve conflicts, communicate clearly, and work together to solve problems.
  1. Accurately perceives the emotional reactions of others.


Customer Focus

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Ensures all customer commitments and requirements are met or exceeded.
  1. Does not hesitate to address customer concerns or complaints.
  1. ...friendliness and courtesy
  1. Considers customers point of view when making decisions.
  1. Asks questions and listens carefully to determine customer needs and to ensure that the customer's needs are met.


Partnering/Networking

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Capitalizes on partnerships and networks to enhance the Company's bottom line.
  1. Maintains infrastructure to support partnerships and networks.
  1. Creates value within the Company by building networks.
  1. Develops a sense of trust in subordinates so they can freely interact and share information with others.
  1. Partners with peers to obtain influence within the Company.


Strategic Insight

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Identifies root causes of problems.
  1. Analyzes records and reports to obtain insight into potential issues and trends.
  1. Analyzes unique issues or problems impacting the Company.
  1. Maintains knowledge of current trends in the industry.
  1. Implements long-term solutions to problems.


Organizational Fluency

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Anticipates problems that may affect the department.
  1. Gets things done through the department.
  1. Understands the current organizational culture.
  1. Adept at navigating within the culture of the department.
  1. Able to use corporate politics to advance department objectives.


Fiscal Management

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Effectively manages appropriations, reporting, purchases, expenditures, payrolls, and staff.
  1. Monitors expenses and verifies the need for items purchased.
  1. Keeps excellent records for financial transparency.
  1. Develops budgets and plans for various programs and initiatives.
  1. Develops of the department's annual budget.


Global Perspective

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Can effectively deliver presentations to international clients.
  1. Understands how cultures differ and how these differences impact work behavior.
  1. Demonstrates working knowledge of global transactions.
  1. Aligns personal vision with global strategies.
  1. Forms strong client relationships with international partners.



  1. Overall, please rate the effectiveness of .






  2. Strengths


  3. Areas for Development


  4. Please give any final comments or suggestions for 's assessment.