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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. I execute effective plan to tackle problems highlighted by feedback.
  1. You seek feedback to enhance performance.
  1. You create an environment that encourage open communication, mutual respect, and continuous improvement to facilitate effective feedback between managers and their employees.
  1. You help employees transform their feedback results into practical steps.
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 embrace changes in technology and automation.
  1. You are able to adjust to changing environments.
  1. You are able to recognize the potential benefits of change, and create an infrastructure which supports change.
  1. You pivot quickly in response to shifting project needs.
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 leverage skills and resources to exceed expectations on projects.
  1. You work quickly when faced with difficult problems.
  1. I identify needs and take steps to address them.
  1. I complete tasks on time in spite of delays in the process.
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 never betrays the trust of confidential sources of information.
  1. I place trust in subordinates to succeed.
  1. You are able to increase the performance of under-performing employees.
  1. You influence [Company]
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 promote training and development opportunities to enhance job performance.
  1. I foster a culture of open communication and continuous improvement.
  1. You are open to the suggestions from others.
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 encourage employees to take additional training in areas where they had low performance scores.
  1. You are consistent in disciplinary/corrective actions.
  1. I recognize employees who have courage in persevering against great odds and difficulties.
  1. I participate in training as needed to improve job performance.
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. I prepare financial statements or reports.
  1. You review documents for grammatical, spelling, or formatting errors to ensure accuracy and professionalism.
  1. You prepare and distribute documents/reports.
  1. You understand the implications of new information for both current and future problem-solving and decision-making.
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 can multitask while performing all of your other responsibilities and activities.
  1. You build in extra time in the schedule for unplanned events/occurrences.
  1. You plan and organize continuously while performing all other responsibilities and activities.
  1. You recognize and respond to product placement and signing needs while staying alert to customers' needs, store activities and training associates.
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 support employee training and development initiatives regarding implementation of technology.
  1. You identify gaps between actual and needed technical competencies and provide recommendations for required training.
  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 maintain open and regular communication with others.
  1. You assist those in the department who need help in meeting performance metrics.
  1. You build a strong rapport with co-workers.
  1. You address critical customer issues in a timely manner.
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 set performance objectives for subordinates that encourages development opportunities.
  1. You develop employees by offering and encouraging them to take on new or additional responsibilities.
  1. You create a work environment that fosters positive feedback to employees.
  1. You create opportunities for professional development.
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. I recognize the individual needs of customers.
  1. I prioritize risks based on an understanding of their possible impact to the company.
  1. You ask the 'right' questions to size up or evaluate situations.
  1. I describe and summarize data.
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.