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Excellence - 360 Degree Feedback Survey Sample #5





360-Degree Assessment Survey

Questionnaires Measuring Excellence:
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)
Survey 13 (4-point scale; numbers; floating anchors)
Survey 14 (4-point scale; 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.

Sample Result Document:
Sample Results
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



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Excellence

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Keeps themselves and others focused on constant improvement.
  1. Demonstrates the analytical skills to do their job.
  1. Takes a lot of pride in their work.
  1. Can be counted on to add value wherever they are involved.
  1. Demonstrates the functional or technical skills necessary to do their job.


Punctuality

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Avoids making personal phone calls during working hours.
  1. Invoices clients on a timely basis.
  1. Conducts appointments at scheduled start time.
  1. Arrives to meetings on time.
  1. Responds to requests for information in a timely manner.


Time Management

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Able to get the important jobs done on time.
  1. Prioritizes critical tasks for the beginning of the shift.
  1. Outperforms others in productivity through effective time management.
  1. Accomplishes more despite limitations in time constraints.
  1. Sets clearly defined goals.


Commitment To Result

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Able to focus on a task even when working alone.
  1. Committed to the team.
  1. Conveys strong sense of own pride in Company to associates by creating a shared vision around sales and customer service.
  1. Coordinates all department activities into a cohesive team effort.
  1. Maintains persistence and dedication to achieving results.


Technology Use/Management

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Understands and is committed to implementing new technologies.
  1. Adopts the implementation of new technology into the workplace.
  1. Proficient in the use of technical systems and processes.
  1. Applies complex rules and regulations to maintain optimal system performance.
  1. Supports technical training and development of employees.


Vision

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Creates an ambitious and aspirational vision for the company.
  1. Entrusts team members with executing the vision.
  1. Encourages employees to prioritize activities that contribute to the vision.
  1. Brings the strategic vision to fruition by planning, coordinating, and executing necessary actions, while ensuring the team meets the overarching goals of the organization.
  1. Creates a crystal-clear vision for where the department needs to be in the next 12 months.



  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.