Innovation - 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.

Innovation	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You create new programs and systems.
You challenge current procedures to develop other alternatives.
I encourage innovation from all levels of employees.
You promote innovation as an opportunity to gain competitive advantages in the marketplace.
You offer solutions to problems when talking with clients.
Collaboration	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You work to create innovative ideas from the collaboration with others.
I engage in consensus-building activities.
I give consideration to the innovative ideas presented by others.
You encourage working together to achieve shared goals.
You have the confidence and trust of other partners.
Teamwork	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You act as an effective team player
I am committed to the successful completion of team goals.
I help the team bounce back from obstacles to progress.
I help the team to bounce back from obstacles.
I listen to other team members without interrupting them.
Adaptability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You are open to change and adjusts plans when needed.
You are able to adjust to changing environments.
You are able to work effectively with new people and new teams.
You are flexible and open minded in dealing with others.
You are able to adjust plans to meet new situations.
Analytical	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
I evaluate assumptions before taking actions.
You are willing to seek out and consider alternative viewpoints.
I am open to investigating novel approaches and methods.
You analyze data to meet the needs of your clients.
I prioritize precision in the data collection process.
Commitment To Result	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You create a sense of urgency among the store team members to complete activities, which drive sales.
You are able to focus on a task even when working alone.
You encourage commitment in others to obtain results.
You coordinate all department activities into a cohesive team effort.
You are willing to do whatever it takes-not afraid to have to put in extra effort.
Bias for Action	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You convey a sense of urgency about addressing problems and opportunities
You display high energy and enthusiasm on consistent basis.
You motivate others to achieve or exceed goals
You seek and utilize opportunities for continuous learning and self-development.
You coach others to foster an environment which can adapt quickly and willingly to rapid change.
Safety	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You ensure that all supervisors are aware of regulatory and compliance measures.
You are not afraid to question a potential safety issue observed in the workplace.
You identify predictable hazards in the workplace.
You are committed to safety in the workplace.
You develop safety guidelines for the department.

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

    -Excellent -Good -Average -Poor




42. Would you refer others who are seeking employment to [Company]?
    Yes No
    
    Please provide explanation:
    
    
    
43. 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?
    
    
    
44. What changes do you see [Company] making in order to raise the standards?
    
    
    
45. I feel good about my continued employment with [Company].
    Yes No
    
    If no, please provide explanation:
    
    
    
46. What do you like best about working for [Company]?
    
    
    
47. 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: