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 ask others for their ideas and opinions.
You look to others for input.
You accept the views of others.
You share past experiences with others as learning opportunities.
You are easy to approach with ideas and opinions.
Performance	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You effectively organize resources and plans
You listen and respond to issues and problems
You work effectively in the department.
You produce quality
You shown significant improvement in job performance.
Flexibility	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You are effective in incorporating new ideas.
You adapt to circumstances as needed.
You act decisively in frequently changing and uncertain environment.
You can handle changes without complaining.
You work effectively during periods of change.
Adaptability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You are flexible and open to new ideas and encourages others to value change.
You continually try to improve skills to remain current.
You will stop what you are doing to help colleagues in need.
You are able to adapt to changes in technology and processes.
You are able to adjust to changing environments.
Bias for Action	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You motivate others to achieve or exceed goals
You convey a sense of urgency about addressing problems and opportunities
You display high energy and enthusiasm on consistent basis.
You identify ways to simplify work processes and reduce cycle times
You seek and utilize opportunities for continuous learning and self-development.
Problem Solving	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You actively seek the root cause of a problem.
You are able to balance the needs of different people in a solution to a problem.
You are effective in solving problems.
You identify fresh approaches and shows a willingness to question traditional assumptions.
You make judgments based upon relevant information.
Results Oriented	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You provide clear expectations for employees.
You stay focused on meeting the needs of customers.
You do not become distracted by non-issues or interruptions.
You work toward achievement of goals even when confronted with obstacles.
You direct team in prioritizing daily work activities
Safety	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You ensure compliance with safety regulations.
You are committed to safety in the workplace.
You support our company's safety programs.
You encourage others to work safely.
You commit adequate resources toward safety measures.
Customer Focus	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You create high quality products for the customers.
You are able to handle difficult customers.
You consider customers point of view when making decisions.
I understand what resources are needed to meet customer needs.
You look for opportunities that have a positive impact on customers.
Partnering/Networking	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You develop a sense of trust in subordinates so they can freely interact and share information with others.
You support a partnering/networking culture.
You build alliances between departments and teams.
You seek an understanding of diverse functions within the Company.
You capitalize on partnerships and networks to enhance the Company's bottom line.
Conflict Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You assist team members by helping them see the other point of view.
You identify and takes steps to prevent potential confrontations.
You try to understand others' point of view before making judgments
You deal effectively with employee grievances.
You clearly express expectations to others.

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: