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Feedback - 360 Degree Feedback Survey Sample #1





360-Degree Feedback Survey

Questionnaires Measuring Feedback:
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)
Instructions for Employees Participating in the 360-Feedback Assessment:

[Company] is conducting a 360-Degree Feedback Assessment developed by HR-Survey for selected managers.

You have been selected to receive feedback from a group of others. As part of this process, you will need to complete a self-assessment questionnaire at this time. Your feedback is an important part of our company's leadership development process and this survey 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 questions below, think about your experiences over the last 12 months. The effectiveness of this development tool is dependent on your honest, forthright and constructive responses so please bear this in mind as you answer each question. Your responses will be combined with the responses received from others and a report will be generated for you to foster growth and on-going 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.

Competencies Included:
Feedback, Adaptability, Action, Leadership, Continual Improvement, Managing Performance, Administrative Skill, Juggling Multiple Responsibilities, Technology Use/Management, Interpersonal Skills, Developing Others, Business Acumen
Sample Result Document:
Sample Results
Your feedback is valuable in helping the individual to understand how they are perceived and experienced by others and the impact their behavior has on people in the organization with whom they interact. Feedback received also acknowledges strengths and identifies areas for development.

Use the form below to provide your feedback. Each field and comment box requires a response before you can SUBMIT your final feedback.

Please ensure that your submission is made between . The survey will only be available during these dates.

Thank you for your participation in the survey. We look forward to seeing the analysis of your responses and we are hoping for 100% participation.

Management Team
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Feedback

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You consider other's opinion and suggestions.
  1. You are easy to approach with ideas and opinions.
  1. You are visible and approachable.
  1. You seek feedback to enhance performance.
If you were to make improvements in Feedback, what are your suggestions for how you can improve this?

Adaptability

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You adjust priorities to changing business goals.
  1. You respond quickly to new information.
  1. You are able to adjusts tactics when things are not working as expected.
  1. You are aware of changes in the environment.
If you were to make improvements in Adaptability, what are your suggestions for how you can improve this?

Action

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. I rapidly adapt to changes in the situation.
  1. You are not afraid to take corrective action when necessary.
  1. You start immediately working on assignments.
  1. You undertake actions to achieve specific goals.
If you were to make improvements in Action, what are your suggestions for how you can improve this?

Leadership

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You give inspiring presentations or discussions.
  1. You act decisively in implementing decisions.
  1. You are a highly effective supervisor.
  1. You motivate and challenges employees to attain a shared vision.
If you were to make improvements in Leadership, what are your suggestions for how you can improve this?

Continual Improvement

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You encourage an employee culture of continuous improvement to seek out better ways of doing things.
  1. You look for ways to expand and learn new job skills.
  1. You look for ways to improve work processes and procedures.
  1. You look for ways to expand current job responsibilities.
If you were to make improvements in Continual Improvement, what are your suggestions for how you can improve this?

Managing Performance

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. I implement remediation plans as needed.
  1. You effectively use the current performance review process.
  1. I am proactive in administering the rewards program.
  1. You ensure employees are accountable for meeting OKRs.
If you were to make improvements in Managing Performance, what are your suggestions for how you can improve this?

Administrative Skill

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You implement and use performance measures.
  1. You are enthusiastic about taking on challenging projects.
  1. You have strong technical/computer skills.
  1. You have strong organizational skills to keep the workspace and department in order
If you were to make improvements in Administrative Skill, what are your suggestions for how you can improve this?

Juggling Multiple Responsibilities

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You build in extra time in the schedule for unplanned events/occurrences.
  1. You observe, analyze, and respond to merchandise needs while serving customers and accomplishing operational tasks.
  1. You determine which tasks are critical and which tasks are optional.
  1. You manage impact of increased traffic flow and freight receipt by detailed planning of controllables and by anticipating and reacting positively to uncontrollables.
If you were to make improvements in Juggling Multiple Responsibilities, what are your suggestions for how you can improve this?

Technology Use/Management

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You use technology in decision making and problem solving.
  1. You are proficient in the use of technical systems and processes.
  1. You maximize the use of new technology to deliver products and services.
  1. You apply complex rules and regulations to maintain optimal system performance.
If you were to make improvements in Technology Use/Management, what are your suggestions for how you can improve this?

Interpersonal Skills

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You recognize the contributions of others.
  1. You create an atmosphere that supports the open expression of ideas
  1. I appreciate the extra efforts made by coworkers.
  1. You a good listener who is attentive to others. I am a good listener who is attentive to others.
If you were to make improvements in Interpersonal Skills, what are your suggestions for how you can improve this?

Developing Others

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You encourage employees through recognition of positive changes in behavior.
  1. You are open to receiving feedback.
  1. You develop employees by offering and encouraging them to take on new or additional responsibilities.
  1. You assess employees' developmental needs.
If you were to make improvements in Developing Others, what are your suggestions for how you can improve this?

Business Acumen

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You evaluate risks in terms of their business impact and likelihood of occurrence.
  1. I am adept at recognizing new opportunities and fostering a culture of innovation ensuring the organization stays ahead of industry trends and continues to evolve.
  1. You are up-to-date with regulatory guidelines and policies.
  1. You understand complex issues and problems.
If you were to make improvements in Business Acumen, what are your suggestions for how you can improve this?

  1. What are [Participant Name Here]'s greatest strengths demonstrated this year?


  2. What are [Participant Name Here]'s areas for development?


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