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.

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Innovation	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You solve problems with insight and understanding.
You analyze current procedures and identify opportunities for improvement.
You find creative ways to get things done with limited resources.
You develop new products and services.
You suggest new ideas at meetings.
Collaboration	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You create an environment to support free exchange of information.
You build consensus among partners.
You readily share information with other group members.
You a dependable partner in the group.
You work to create innovative ideas from the collaboration with others.
Teamwork	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You carry your share of the workload
You relate to all kinds of people tactfully
You recognize and respects the contributions and needs of each individual.
You actively participates as a team member
You coach team members
Adaptability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You are aware of changes to team personnel.
You respond quickly to new information.
You will stop what you are doing to help colleagues in need.
You adjust plans to meet the needs of new constraints.
You work effectively with various personalities of team members.
Analytical	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You identify the root cause of a problem.
You implement data validation techniques and methods.
You select the appropriate techniques for analysis.
You balance risks and costs with the reward and probabilities of success when decisions.
You analyze data and information from several sources and arrives at logical conclusions.
Commitment To Result	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You are willing to do whatever it takes-not afraid to have to put in extra effort.
You are committed to the team.
You create a sense of urgency among the store team members to complete activities, which drive sales.
You take immediate action toward goals.
You convey strong sense of own pride in Company to associates by creating a shared vision around sales and customer service.
Bias for Action	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You seek and utilize opportunities for continuous learning and self-development.
You convey a sense of urgency about addressing problems and opportunities
You display high energy and enthusiasm on consistent basis.
You project a "can-do" attitude when interfacing with peers, subordinates and customers(especially during difficult and challenging times).
You motivate others to achieve or exceed goals
Safety	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You participate in safety training as applicable.
You are not afraid to question a potential safety issue observed in the workplace.
You create accurate and effective measures of safety.
You identify and addresses safety needs.
You encourage others to attend safety training.

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: