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 develop new products and services.
You challenge current procedures to develop other alternatives.
You build upon the ideas and solutions of others.
You suggest new ideas at meetings.
You search for opportunities and innovative ways to improve the organization.
Collaboration	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You share skills and time to help the team thrive.
You are open to unique and creative ideas from others.
You work to create innovative ideas from the collaboration with others.
You guide team members to reconcile their differences and collaborate effectively.
I strengthen relationships with suppliers to improve contract and price negotiation terms.
Teamwork	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
I facilitate effective decision-making practices to further develop the team.
You carry your share of the workload
I make decisions that support the team's goals and objectives.
I am able to work closely other team members who are considered to be difficult to work with.
You show respect for other team members.
Adaptability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You are flexible and open minded in dealing with others.
You recognize and implement changes to enhance efficiency and effectiveness.
I embrace change and foster an open-minded environment.
You are able to work effectively with new people and new teams.
You are able to recognize the potential benefits of change, and create an infrastructure which supports change.
Analytical	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You identify the root cause of a problem.
You analyze data and information from several sources and arrives at logical conclusions.
You analyze issues and reduce them to their component parts.
You identify problems and issues needing resolution.
You use appropriate techniques to solve problems.
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 encourage commitment in others to obtain results.
You are able to focus on a task even when working alone.
You take immediate action toward goals.
You maintain persistence and dedication to achieving results.
Bias for Action	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You coach others to foster an environment which can adapt quickly and willingly to rapid change.
You identify ways to simplify work processes and reduce cycle times
You complete work on time
You complete a large volume of work.
You project a "can-do" attitude when interfacing with peers, subordinates and customers(especially during difficult and challenging times).
Safety	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You develop a culture of safety.
You point out behaviors in others that may be unsafe.
You seek to reduce the likelihood of accidents.
You encourage others to attend safety training.
You participate in safety training when offered.

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: