Feedback - 360 Degree Feedback Survey Sample #4

Dear Employee:

Welcome to our 360-Degree Feedback self-assessment questionnaire. Our objective is to provide feedback which will help advance your leadership skills and capabilities. We are asking you to take time to respond to this survey to help us identify areas where you are doing well and where you have opportunities to do better. Others will also complete the questionnaire to provide you with feedback.

We have developed this survey with questions tailored for your position in the department to provide you with an opportunity to rate many facets of your leadership performance.

Please be honest, constructive and thoughtful in your responses. The results of this survey will be used to help drive our future success. If you have any questions about the process please contact [Contact Person].

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



Instructions:
Please complete the items below and press the submit button at the end of the survey. If you need multiple sessions to complete the survey, please click the "Submit" button at the end of each session to save your responses. Please feel free to skip any items that you do not wish to respond to. Keep in mind that your responses help us to become a better place to work. So, you are encouraged to respond to all items on the questionnaire.

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Feedback	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You share past experiences with others as learning opportunities.
You are visible and approachable.
You ask others for their ideas and opinions.
You are easy to approach with ideas and opinions.
You actively seek feedback from others.
Performance	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You work effectively in the department.
You produce quality
You shown significant improvement in job performance.
You effectively organize resources and plans
You set a high standard for job performance.
Flexibility	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
I foster an inclusive learning environment where everyone feels supported, ultimately leading to stronger team cohesion and increased productivity.
You allow for flexibility in the agenda for the team meeting.
You are able to change your approach to solving a problem based on new information.
I pivot strategies, operations, or processes in real-time to meet new challenges or seize new opportunities.
I am able to adapt and tailor approaches based on the unique requirements of each scenario.
Adaptability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You adapt quickly to new situations.
You adjust priorities to changing business goals.
You can adjust tactics and strategies.
You are aware of changes to team personnel.
You adapt to changes in team membership.
Bias for Action	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You display high energy and enthusiasm on consistent basis.
You encourage risk taking and experimentation to improve performance
You identify ways to simplify work processes and reduce cycle times
You complete a large volume of work.
You complete work on time
Problem Solving	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
I allocate resources strategically to areas with higher risk potential.
I facilitate rapid development and exchange of ideas.
I assess whether the proposed solutions are practical and achievable.
I maintain a strong and determined attitude in the face of difficulties.
I evaluate whether the necessary resources (budget, personnel, time, technology) are available to implement each solution.
Results Oriented	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
I prioritize tasks to best achieve the results.
You determine the parts of the project that need completed first.
You exceed performance requirements.
You encourage employees to give 100% to achieving high results.
You have a work ethic with a strong desire to obtain results.
Safety	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You participate in safety training as applicable.
You are committed to safety in the workplace.
You commit adequate resources toward safety measures.
You develop a sustainable safety culture.
You work to implement corrective safety measures.
Customer Focus	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You look for opportunities that have a positive impact on customers.
You thoroughly understand the needs of the customer.
You anticipate problems that the customer may encounter.
I prioritize customer issues based on urgency.
You effectively troubleshoot customer issues.
Partnering/Networking	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You create opportunities and incentives for employees to learn and share knowledge with others.
I build alliances with others in the company.
You regularly schedule coffee chats or informal meetups to deepen personal connections.
You develop internal alliances with others in the department.
You can perform a risk assessment to show a balanced view of the partnership’s potential outcomes.
Conflict Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You facilitate constructive dialog with stakeholders.
I work to settle conflicts in a manner that is acceptable for a long-term solution.
I seeks to have both sides voluntarily work together to resolve their differences.
I seek to achieve mutually acceptable outcomes.
You guide others toward establishing strong relationships.

56. On a scale of Excellent to Poor, how would you rate your overall employment with [Company] and why?
    

    -Excellent -Good -Average -Poor




57. Would you refer others who are seeking employment to [Company]?
    Yes No
    
    Please provide explanation:
    
    
    
58. If you had an opportunity to make any change you wanted to make [Company] a better place to work, what one improvement would you make?
    
    
    
59. What changes do you see [Company] making in order to raise the standards?
    
    
    
60. I feel good about my continued employment with [Company].
    Yes No
    
    If no, please provide explanation:
    
    
    
61. What do you like best about working for [Company]?
    
    
    
62. What do you like least about working for [Company]? How could it be improved?
    
    
    
93. Use the space below to enter any final comments you would like to be noted: