Emotional Intelligence - 360 Degree Feedback Survey Sample #9

360 Feedback Survey

Self-Assessment Instructions

Thank you for agreeing to participate in this leadership training process. As part of this process, you will be completing the self-assessment questionnaire (below). As you respond, please draw on your work experiences over the past 12 months. Rate each item using the scale shown. Comments at the end can help you to explain your ratings. If you gave a particularly high or low rating, please share your reasons in the comment section for that competency. Your responses will be compiled with feedback from others and presented to you at the next leadership seminar to help guide your ongoing professional 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.

Emotional Intelligence	Definite Strength	Meets Standards	Needs Development	N/A
You are able to control your own emotions.
You help to make decisions and solve problems using knowledge about how others will react in certain situations.
You are able to manage your own emotions.
You accurately perceive the emotional reactions of others.
You are attentive to emotional cues and interprets others' feelings correctly.
Communication Skills	Definite Strength	Meets Standards	Needs Development	N/A
You inform others about changes or developments in plans and goals.
I ensure comprehension during conversations or group presentations.
I keep an open-door policy to provide support and guidance.
You summarize or paraphrase the current question to confirm understanding.
You consider the audience in how the communication is presented.
Flexibility	Definite Strength	Meets Standards	Needs Development	N/A
You can handle changes without complaining.
You are able to adapt to new situations.
I can easily accommodate changes in personnel of the department.
I exhibit exceptional adaptability in responding to unexpected challenges.
I am willing to change ideas or perceptions based on new information.
Bias for Action	Definite Strength	Meets Standards	Needs Development	N/A
You motivate others to achieve or exceed goals
You display high energy and enthusiasm on consistent basis.
You identify ways to simplify work processes and reduce cycle times
You complete work on time
You encourage risk taking and experimentation to improve performance
Supervisory Skills	Definite Strength	Meets Standards	Needs Development	N/A
You encourage employees to achieve your full potential.
I inform employees of what tasks need to be completed on each shift.
I maintain a calm demeanor when addressing stressful issues in the workplace.
I offer instructions and guidance to subordinates.
I meet with employees at the end of the job to debrief them.
Analytical	Definite Strength	Meets Standards	Needs Development	N/A
You identify problems and issues needing resolution.
You use appropriate techniques to solve problems.
You analyze data and information from several sources and arrives at logical conclusions.
You ask the "right" questions to size up or evaluate situations.
You analyze issues and reduce them to their component parts.
Goals	Definite Strength	Meets Standards	Needs Development	N/A
You achieve established goals.
You understand and contribute to development of strategic goals.
You set challenging stretch goals
You achieve goals.
You make sure that team members have a clear idea of our group's goals.
Technology Use/Management	Definite Strength	Meets Standards	Needs Development	N/A
You use technology in decision making and problem solving.
You support technical training and development of employees.
You apply complex rules and regulations to maintain optimal system performance.
You understand and are committed to implementing new technologies.
You are proficient in the use of technical systems and processes.
Co-worker Development	Definite Strength	Meets Standards	Needs Development	N/A
You set and clearly communicate expectations, performance goals, and measurements to others
You provide ongoing feedback to co-workers on your development progress
You work to identify root causes of performance problems
You take immediate action on poor performance
You give others development opportunities through project assignments and increased job responsibilities
Others	Definite Strength	Meets Standards	Needs Development	N/A
You include others in the decision making processes.
You support the efforts of other employees in implementing solutions to problems.
You consistently demonstrate ability and willingness to trust others.
You treat others with respect and dignity.
You work effectively with people from other departments.
Strategic Insight	Definite Strength	Meets Standards	Needs Development	N/A
You identify root causes of problems.
You create a mission statement describing the purpose for the organization.
I attend industry conferences to gain further insight into how other companies deal with similar issues.
I pursue strategic alliances with valued partners.
You let employees know how their roles contribute toward the achievement of strategic company objectives.

56. Overall, please rate the effectiveness of [Participant Name Here].
    

    5- Very Effective 4- Effective 3- Neither 2- Ineffective 1- Very Ineffective

    
    
57. Strengths
    
    
    
58. Areas for Development
    
    
    
59. Please give any final comments or suggestions for [Participant Name Here]'s assessment.