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)
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 .


Agree Unsure Disagree N/A
  1. Demonstrates the analytical skills to do their job.
  1. Demonstrates the functional or technical skills necessary to do their job.
  1. Takes a lot of pride in their work.
  1. Keeps themselves and others focused on constant improvement.
  1. Can be counted on to add value wherever they are involved.

Communication Skills

Agree Unsure Disagree N/A
  1. Gives clear and convincing presentations.
  1. Has the confidence to communicate effectively to all levels (from CEO down) of the organization, external customers, suppliers, as well as the senior counsel of other companies.
  1. Able to demonstrate persuasiveness in pursuit of objectives.
  1. Presents issues, ideas, and strategy concisely and clearly.
  1. Communicates effectively with all levels of the organization.


Agree Unsure Disagree N/A
  1. Protects the integrity and confidentiality of information
  1. Fosters a high standard of ethics and integrity.
  1. Demonstrates honesty and truthfulness at all times.
  1. Demonstrates sincerity in actions with others.
  1. Maintains strong relationships with others.


Agree Unsure Disagree N/A
  1. Actively seeks feedback from others.
  1. Asks others for their ideas and opinions.
  1. Seeks feedback to enhance performance.
  1. Accepts the views of others.
  1. Considers other's opinion and suggestions.

Project Management

Agree Unsure Disagree N/A
  1. Organizes, plans, and directs resources to accomplish the goals and objectives.
  1. Develops action items, workplans, timelines, and criteria for projects.
  1. Inspires others to accomplish goals and objectives.
  1. Able to adjust project schedule as needed to accommodate unforeseen issues.
  1. Maintains costs and expenses within budget limits.


Agree Unsure Disagree N/A
  1. Reflects on what is working and what could be improved.
  1. Always strives to produce the highest quality work products.
  1. Analyze what occurred and re-adjusts accordingly when goals are not met.
  1. Encourages others to produce the highest quality work products.
  1. Holds employees accountable for their quality of work.

Time Management

Agree Unsure Disagree N/A
  1. Sets clearly defined goals.
  1. Completes high-priority work within required timelines.
  1. Sets a good balance between work and family life.
  1. Keeps and maintains a To-Do list.
  1. Completes tasks ahead of schedule.

Results Oriented

Agree Unsure Disagree N/A
  1. Directs team in prioritizing daily work activities
  1. Works toward achievement of goals even when confronted with obstacles.
  1. Helps others when free-time is available.
  1. Provides clear expectations for employees.
  1. Explains the "whys" behind organizational objectives

Empowering Others

Agree Unsure Disagree N/A
  1. Willing to share in the decision making process.
  1. Demonstrates confidence in the abilities of subordinates.
  1. Gives employees input into the decision making process.
  1. Lets employees complete tasks according to their methods.
  1. Expresses confidence in the abilities of others.


Agree Unsure Disagree N/A
  1. Makes people around them feel appreciated and valued.
  1. Lets employees know when they have done well
  1. Reinforces and rewards employees for accomplishing necessary goals.
  1. Recognizes individuals for a specific outstanding achievement.
  1. Recognizes team members who offer a significant contribution to a project.

Fiscal Management

Agree Unsure Disagree N/A
  1. Develops of the department's annual budget.
  1. Keeps excellent records for financial transparency.
  1. Monitors spending.
  1. Effectively manages appropriations, reporting, purchases, expenditures, payrolls, and staff.
  1. Effective in using Company's resources.

  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.