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.

---

Edit this Survey

Would you like to edit this survey? Click here to begin.

Feedback	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You foster a culture of dialogue and performance insights at all levels is viewed as essential for effective feedback in crucial interactions between employees and their managers.
I ask clarifying questions to ensure full understanding before responding.
I recognize feedback as a vital catalyst for personal and professional development.
You use feedback appropriately for professional development.
You maintain the confidentiality of feedback given.
Performance	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You produce quality
You shown significant improvement in job performance.
You have great overall performance
You set a high standard for job performance.
You work well in this position.
Flexibility	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
I adapt processes and procedures in response to changes in the work environment.
You identify new opportunities to achieve goals
You adapt quickly to new technologies that impact the production line.
I permit flexible working and flex-time to accommodate employee needs to meet external obligations.
You foster agility in process and decision-making.
Adaptability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You adjust communication style to meet the needs of the audience.
You learn new skills to become competitive and contribute to the bottom line.
You are able to adjust to changing environments.
You are open to change and adjusts plans when needed.
I am willing to change priorities as need to reach consensus.
Bias for Action	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You project a "can-do" attitude when interfacing with peers, subordinates and customers(especially during difficult and challenging times).
You establish clear and actionable goals to guide the team's efforts and ensure progress.
You focus on results through actions that are always aimed at achieving tangible results and meeting deadlines.
You are motivated to accomplish goals.
You convert the strategic plan into action
Problem Solving	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
I pinpoint the issues that have arisen or are expected to arise.
You keep a positive outlook and perseveres through challenges.
I create a timeline for completing the action steps including deadlines for each task and milestones to be achieved.
I conduct a thorough and careful analysis of the underlying causes of problems.
You are able to solve problems at root cause rather than at symptom level.
Results Oriented	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
I maintain focus on end goals while adapting the path to get there.
I proactively identify when others need assistance and offer help without being asked.
I excel in dynamic environments.
You are considered a high achiever.
You stay focused on meeting the needs of customers.
Safety	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You identify and addresses safety needs.
You develop a sustainable safety culture.
You perform work safely.
You encourage others to work safely.
You participate in safety training when available.
Customer Focus	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You deliver on commitments made to customers.
You get feedback from the customer on a weekly basis.
I use product expertise to guide customers toward a satisfy choice.
I make sure customer needs are understood by the team members.
You adapt to changing customer needs.
Partnering/Networking	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You can perform a risk assessment to show a balanced view of the partnership’s potential outcomes.
I can perform a SWOT analyses (Strengths, Weaknesses, Opportunities, Threats) of the partnership's potential outcomes.
You create opportunities and incentives for employees to learn and share knowledge with others.
I develop networks and builds alliances.
I synchronize efforts, processes, and resources with partners to enhance strategic opportunities.
Conflict Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
I avoid engaging in conflicts over minor workplace matters.
You create balance in discussions by draw out perspectives that may otherwise go unheard.
You craft messages that resonate better with the parties involved, making it easier to convey concerns and perspectives in a constructive manner.
You value the diverse perspectives of others.
I encourage teams to extract lessons from conflict and apply them to improve processes, relationships, or strategy.

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: