Excellence - 360 Degree Feedback Survey Sample #8

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)

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.

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 .


Agree Unsure Disagree N/A
  1. Demonstrates the functional or technical skills necessary to do their job.
  1. Can be counted on to add value wherever they are involved.
  1. Produces high quality work.
  1. Demonstrates the analytical skills to do their job.
  1. Is planful and organized.

Communication Skills

Agree Unsure Disagree N/A
  1. Able to demonstrate persuasiveness in pursuit of objectives.
  1. Checks for understanding throughout conversations or group presentations/discussions
  1. Listens to others' points of view with an open mind
  1. Chooses the communication medium (ie. email, voice mail, memo, project document) that reflects the needs of the content. (ie. urgency, confidentiality, content scope)
  1. Communicates effectively with colleagues and customers


Agree Unsure Disagree N/A
  1. Protects the integrity and confidentiality of information
  1. Maintains strong relationships with others.
  1. Establishes relationships of trust, honesty, fairness, and integrity.
  1. Accepts responsibility for mistakes.
  1. Follows tasks to completion.


Agree Unsure Disagree N/A
  1. Asks others for their ideas and opinions.
  1. Seeks feedback to enhance performance.
  1. Open to the suggestions of others.
  1. Considers other's opinion and suggestions.
  1. Is visible and approachable.

Project Management

Agree Unsure Disagree N/A
  1. Works with customers and clients to assess their needs and define project parameters.
  1. Defines project outcomes based on customer requirements.
  1. Organizes work and sets priorities as needed.
  1. Inspires others to accomplish goals and objectives.
  1. Organizes, plans, and directs resources to accomplish the goals and objectives.


Agree Unsure Disagree N/A
  1. Holds employees accountable for their quality of work.
  1. Encourages employees to produce the best quality products.
  1. Reflects on what is working and what could be improved.
  1. Always strives to produce the highest quality work products.
  1. Corrects issues in a timely manner.

Time Management

Agree Unsure Disagree N/A
  1. Sets clearly defined goals.
  1. Makes time for developing plans and schedules.
  1. Keeps and maintains a To-Do list.
  1. Deals effectively with interruptions.
  1. Completes high-priority work within required timelines.

Results Oriented

Agree Unsure Disagree N/A
  1. Does not become distracted by non-issues or interruptions.
  1. Works toward achievement of goals even when confronted with obstacles.
  1. Provides clear expectations for employees.
  1. Encourages a high-energy, fun work environment and coaches others on how to do the same
  1. Stays focused on meeting the needs of customers.

Empowering Others

Agree Unsure Disagree N/A
  1. Encourages others to obtain necessary skills and training.
  1. Avoids micromanaging their employees.
  1. Provides support and resources needed to accomplish goals.
  1. Allows individuals to be responsible for their decisions.
  1. Sets clear goals for others to accomplish.


Agree Unsure Disagree N/A
  1. Compliments other people when they do good work
  1. Offers recognition in a timely manner.
  1. Makes people around them feel appreciated and valued.
  1. Recognizes the abilities and skills of self and others
  1. Says "thank you" to show appreciation for work of others.

Fiscal Management

Agree Unsure Disagree N/A
  1. Effective in using Company's resources.
  1. Develops budgets and plans for various programs and initiatives.
  1. Provides budgeting and accounting support to the Company.
  1. Ensures others follow the correct rules and regulations on fiscal matters.
  1. Monitors expenses and verifies the need for items purchased.

  1. Overall, please rate the effectiveness of .

  2. Strengths

  3. Areas for Development

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