Innovation - 360 Degree Feedback Survey Sample #8

Questionnaires Measuring Innovation:
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)

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.

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. Implements best practices within the department.
  1. Analyzes current procedures and identifies opportunities for improvement.
  1. Challenges current procedures to develop other alternatives.
  1. Builds upon the ideas and solutions of others.
  1. Offers constructive improvements to existing systems.


Agree Unsure Disagree N/A
  1. Sets high expectations and goals; encourages others to support the organization.
  1. Achieves established goals.
  1. Understands & contributes to development of strategic goals.
  1. Goal Setting
  1. Makes sure that I have a clear idea of our group's goals.

Results Oriented

Agree Unsure Disagree N/A
  1. Demonstrates the personal confidence to "stay the course," even when faced with difficulty
  1. Does not become distracted by non-issues or interruptions.
  1. Directs team in prioritizing daily work activities
  1. Provides clear expectations for employees.
  1. Works toward achievement of goals even when confronted with obstacles.


Agree Unsure Disagree N/A
  1. Is planful and organized.
  1. Takes a lot of pride in their work.
  1. Keeps themselves and others focused on constant improvement.
  1. Produces high quality work.
  1. Demonstrates the functional or technical skills necessary to do their job.

Interpersonal Skills

Agree Unsure Disagree N/A
  1. Is open and approachable
  1. Adapts management style to meet the needs of the individual or situation.
  1. Uses tact, compassion, and sensitivity in interactions with others.
  1. Anticipates the concerns of other employees.
  1. Is a role model for others

Customer Focus

Agree Unsure Disagree N/A
  1. Consistently models positive customer service attitudes.
  1. Does not hesitate to address customer concerns or complaints.
  1. Ensures all customer commitments and requirements are met or exceeded.
  1. Maintains positive customer relationships.
  1. Develops good rapport and trust with the customer.


Agree Unsure Disagree N/A
  1. Seeks an understanding of diverse functions within the Company.
  1. Supports a partnering/networking culture.
  1. Creates value within the Company by building networks.
  1. Supports and encourages relationships that are created by diverse team members.
  1. Partners with peers to obtain influence within the Company.

Business Acumen

Agree Unsure Disagree N/A
  1. Considers impact of actions on other areas of the organization.
  1. Applies the knowledge of work processes to influence the achievement of business goals
  1. Asks the 'right' questions to size up or evaluate situations.
  1. Able to align resources to meet the business needs of the company.
  1. Exhibits behavior that is consistent with the vision, mission, and core values of the organization

Strategic Insight

Agree Unsure Disagree N/A
  1. Identifies potential problems before they become critical incidents.
  1. Formulates strategies and action plans to ensure successful completion of goals and objectives.
  1. Analyzes records and reports to obtain insight into potential issues and trends.
  1. Communicates vision for the department and company.
  1. Analyzes unique issues or problems impacting the Company.


Agree Unsure Disagree N/A
  1. Delegates role to team members to accomplish goals.
  1. Works in an organized manner
  1. Makes plans and follows through.
  1. Able to identify the needs of the department before a major change.
  1. Anticipates obstacles and ways to overcome them.

Continual Improvement

Agree Unsure Disagree N/A
  1. Looks for ways to expand and learn new job skills.
  1. Looks for ways to expand current job responsibilities.
  1. Looks for ways to improve work processes and procedures.
  1. Promotes training and development opportunities to enhance job performance.
  1. Open to the suggestions from others.


Agree Unsure Disagree N/A
  1. Starts the workday when scheduled.
  1. Starts meetings on time.
  1. Invoices clients on a timely basis.
  1. Responds to requests for information in a timely manner.
  1. Arrives to meetings on time.

Persuasion and Influence

Agree Unsure Disagree N/A
  1. Attempts to persuade others rather than simply control them.
  1. Has excellent influencing/negotiating skills.
  1. Able to express own goals and needs.
  1. Ensures stakeholders are involved in the decision making process.
  1. Communicates effectively with others.

  1. Overall, please rate the effectiveness of .

  2. Strengths

  3. Areas for Development

  4. Please give any final comments or suggestions for 's assessment.