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)
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


Feedback

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You consider other's opinion and suggestions.
  1. You seek feedback to enhance performance.
  1. You ask others for their ideas and opinions.
  1. You are easy to approach with ideas and opinions.
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 are aware of changes in the environment.
  1. You continually try to improve skills to remain current.
  1. You are able to quickly learn new ways of performing your job.
  1. You are able to work effectively with new people and new teams.
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. You take corrective action when necessary.
  1. I rapidly adapt to changes in the situation.
  1. You make effective decisions, even when under pressure.
  1. I am decisive when making decisions.
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 express clear goals and objectives.
  1. You sit down regularly with employees to review your job performance.
  1. You hold others accountable for your actions.
  1. You are able to influence others.
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 are open to the suggestions from others.
  1. You search for new methods, techniques, and processes that increase efficiency and reduce costs.
  1. You look for ways to improve work processes and procedures.
  1. You promote training and development opportunities to enhance job performance.
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. You create several measures of success for each goal.
  1. I increase responsibilities for high performing individuals.
  1. I am consistent in clearly communicating job requirements.
  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 complete reports on-time.
  1. You have strong organizational skills to keep the workspace and department in order
  1. You have strong technical/computer skills.
  1. You accurately implement contract provisions.
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 coordinate the work of a team by assigning tasks to other team members.
  1. You assign tasks based on skills of team members.
  1. You integrate developing others with driving sales, serving customers, merchandising, performing operational procedures, and maintaining an appealing store environment.
  1. You are aware of the deadlines for specific tasks/assignments.
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 adopt the implementation of new technology into the workplace.
  1. You use technology in decision making and problem solving.
  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.
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. I embrace the differences in individuals that comprise the team.
  1. I give credit where credit is due.
  1. I value the input from coworkers.
  1. You communicate well at all levels of the organization.
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 try to ensure employees are ready to move to the next level.
  1. You assign tasks and responsibilities to develop skills of others.
  1. You provide constructive feedback to others.
  1. You encourage employees through recognition of positive changes in behavior.
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 involve key stakeholders (employees, customers, investors, partners) in the planning process to gain diverse perspectives and buy-in.
  1. You can effectively interpret and analyze data.
  1. You understand complex issues and problems.
  1. You understand financial terminology, statements.
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.