Empowering Others- 360 Degree Feedback Survey Sample #8

Questionnaires Measuring Empowering Others:
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)
Survey 10 (Comment boxes only)
Survey 11 (Single rating per competency)
Survey 12 (Slide-bar scale)

You have been selected to provide feedback for the manager listed above. Your feedback is an important part of 's leadership development process. This tool is intended to gather broad feedback in the core competencies and role responsibilities that are important for the on-going success of our organization.

In responding to the assessment form, please think about your experiences working with this individual during the last six to twelve months. Your responses will be merged with other people's feedback and presented to to guide them in their on-going development. Comments will be shared anonymously, as written, with the manager.

Sample Result Document:
Sample Results
Method of use: As part of the review process, managers will receive feedback from peers and staff. It is recognized that not all participants will be able to assess an individual's performance in all areas. The feedback received will be utilized as input to the manager's performance and on-going development plan.

You may sign out at any time by pressing the Save button at the end of the form and then closing your browser. You may return later to pick up where you left off. When you are done, press the Complete button.

When clicking your selection below, try to best fit the manager's actual behaviors to the scale provided.

If you are not sure, or unable to assess, select "Not Applicable" (N/A) option.

Please complete your response by .

Empowering Others

Agree Unsure Disagree N/A
  1. Gives employees the opportunity to make their own decisions at work.
  1. Sets clear goals for others to accomplish.
  1. Provides support and resources needed to accomplish goals.
  1. Encourages employees to solve problems on their own.
  1. Gives responsibility for making important decisions to employees.

Administrative Skill

Agree Unsure Disagree N/A
  1. High attention to detail.
  1. Completes reports on-time.
  1. Accurately implements contract provisions.
  1. Enthusiastic about taking on challenging projects.
  1. Able to develop, justify and present a budget.


Agree Unsure Disagree N/A
  1. Motivates and challenges employees to attain a shared vision.
  1. Sets specific, measurable, and challenging goals.
  1. Demonstrates leadership and courage in critical situations.
  1. Sits down regularly with employees to review their job performance.
  1. Able to organize the work of others.


Agree Unsure Disagree N/A
  1. Is knowledgeable of procedures or systems necessary for the job.
  1. Demonstrates mastery of the technical competencies required in his/her work.
  1. Knows how to produce high quality products/work.
  1. Is naturally sought out by people outside his/her particular area for advice and opinion on a broad range of matters - not necessarily solely legal advice.
  1. Willingly shares information and expertise; sought out as resource by others


Agree Unsure Disagree N/A
  1. Creates accurate and effective measures of safety.
  1. Commits adequate resources toward safety measures.
  1. Encourages others to work safely.
  1. Participates in safety training as applicable.
  1. Committed to safety in the workplace.


Agree Unsure Disagree N/A
  1. Identifies new opportunities to achieve goals
  1. Adapts to circumstances as needed.
  1. Can handle changes without complaining.
  1. Works effectively during periods of change.
  1. Implements changes as a result of having listened to employees

Conflict Management

Agree Unsure Disagree N/A
  1. Tries to understand others' point of view before making judgments
  1. Discusses conflict situations with supervisor.
  1. Clearly expresses expectations to others.
  1. Deals effectively with employee grievances.
  1. Assists team members by helping them see the other point of view.


Agree Unsure Disagree N/A
  1. Creates a common vision for others.
  1. Persuades others to follow the Company's vision.
  1. Leads employees in new directions.
  1. Works to support the strategy of [Company]
  1. Develops action plans to align his/her work with the goals of the organization

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

  2. Strengths

  3. Areas for Development

  4. Please give any final comments or suggestions for [Participant Name Here]'s assessment.