Goals - 360 Degree Feedback Survey Sample #8

Questionnaires Measuring Goals:
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)

You have been selected to provide feedback for the manager listed above. Your feedback is an important part of 's leadership development process. This tool 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 assessment form, please think about your experiences working with this individual during the last six to twelve months. Your responses will be merged with other people's feedback and presented to to guide them in their on-going development. Comments will be shared anonymously, as written, with the manager.

Sample Result Document:
Sample Results
Method of use: As part of the review process, managers will receive feedback from peers and staff. It is recognized that not all participants will be able to assess an individual's performance in all areas. The feedback received will be utilized as input to the manager's performance and on-going development plan.

You may sign out at any time by pressing the Save button at the end of the form and then closing your browser. You may return later to pick up where you left off. When you are done, press the Complete button.

When clicking your selection below, try to best fit the manager's actual behaviors to the scale provided.

If you are not sure, or unable to assess, select "Not Applicable" (N/A) option.

Please complete your response by .


Agree Unsure Disagree N/A
  1. Establishes and documents goals and objectives.
  1. Goal Setting
  1. Achieves goals.
  1. Achieves established goals.
  1. Makes sure that I have a clear idea of our group's goals.

Juggling Multiple Responsibilities

Agree Unsure Disagree N/A
  1. Switches attention to more urgent tasks when necessary.
  1. Can multitask while performing all of their other responsibilities and activities.
  1. Observes, analyzes, and responds to merchandise needs while serving customers and accomplishing operational tasks.
  1. Is aware of the deadlines for specific tasks/assignments.
  1. Plans and organizes continuously while performing all other responsibilities and activities.

Managing Risk

Agree Unsure Disagree N/A
  1. Is aware of the financial implications of certain risks.
  1. Is concerned about process safety management.
  1. Tracks risks in a project.
  1. Seeks to retain the best and brightest employees.
  1. Accurately perceives potential risks in the workplace.


Agree Unsure Disagree N/A
  1. Offers training to employees to ensure they are complying with regulations.
  1. Works quickly to implement changes in regulations.
  1. Addresses issues quickly before they develop into major problems.
  1. Follows all safety regulations and procedures.
  1. Offers training to employees to ensure they comply with regulations.

Client Focus

Agree Unsure Disagree N/A
  1. Is pro-active in dealing with clients and addressing their needs.
  1. Maintains strong relationships with clients.
  1. Ensures client commitments and requirements are met or exceeded
  1. Forms strong client relationships
  1. Looks for opportunities that have a positive impact on Clients.

Self Management

Agree Unsure Disagree N/A
  1. Consciously controls own negative emotions in order to keep team morale up.
  1. Does not allow own emotions to interfere with the performance of others.
  1. Analyzes interpersonal problems instead of reacting to them.
  1. Deals with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
  1. Uses patience and self-control in working with customers and associates.


Agree Unsure Disagree N/A
  1. Visibly supports and encourages diversity in style and background.
  1. Treats all people fairly and with respect.
  1. Builds open and trusting relationships.
  1. Works to eliminate unnecessary work or barriers that get in others' way.
  1. Contributes to a positive and fun work environment.

Supervisory Skills

Agree Unsure Disagree N/A
  1. Promotes teamwork and cooperation within the department.
  1. Provides constructive, ongoing feedback.
  1. Resolves personnel problems quickly and effectively.
  1. Treats all staff equitably.
  1. Delegates effectively.


Agree Unsure Disagree N/A
  1. ...Overall Performance
  1. Listens and responds to issues and problems
  1. Effectively organizes resources and plans
  1. Able to organize work.
  1. Works effectively in the department.

Problem Solving

Agree Unsure Disagree N/A
  1. Implements effective solutions to critical problems.
  1. Works cooperatively with others to solve problems.
  1. Makes judgments based upon relevant information.
  1. Finds creative ways to get things done with limited resources.
  1. Generates alternative solutions to problems and challenges.


Agree Unsure Disagree N/A
  1. Helps employees to maintain high personal standards.
  1. Develops the skills and capabilities of others.
  1. Meets regularly with employees to coach them on areas that will enhance their performance
  1. Addresses employee behavior problems effectively.
  1. Provides clear, motivating, and constructive feedback.

Business Acumen

Agree Unsure Disagree N/A
  1. Able to align resources to meet the business needs of the company.
  1. Effectively develops and uses resources (people, time, money, supplies, equipment, and space) to improve organizational performance
  1. Understands complex issues and problems.
  1. Exhibits behavior that is consistent with the vision, mission, and core values of the organization
  1. Applies the knowledge of work processes to influence the achievement of business goals

Strategic Insight

Agree Unsure Disagree N/A
  1. Communicates vision for the department and company.
  1. Formulates policies and strategies for addressing the Company's important challenges.
  1. Identifies potential problems before they become critical incidents.
  1. Analyzes records and reports to obtain insight into potential issues and trends.
  1. Maintains knowledge of current trends in the industry.

Organizational Fluency

Agree Unsure Disagree N/A
  1. Able to explain departmental policies and procedures to others.
  1. Able to deal with sensitive issues with tact and professionalism.
  1. Adept at navigating within the culture of the department.
  1. Gets things done through the department.
  1. Understands the current organizational culture.

  1. Overall, please rate the effectiveness of [Participant Name Here].

  2. Strengths

  3. Areas for Development

  4. Please give any final comments or suggestions for [Participant Name Here]'s assessment.