Integrity - 360 Degree Feedback Survey Sample #6

360-Degree Assessment Survey

Dear Employee:

You have been selected to participate in a 360-assessment. As part of this process you will need to complete the self-assessment questionnaire below.

In responding to the questions below, think about your experiences over the last 12 months. The effectiveness of this development tool is dependent on your honest, forthright and constructive responses so please bear this in mind as you answer each question. Your responses will be aggregated with the responses received from others. A report will be shared with you at the conclusion of this project.

We encourage everyone to complete the survey. Please be honest, constructive and thoughtful in your input. The survey is designed to help us understand more about your thoughts and needs to make this a great company.

The results of this survey will be used to help drive our future success. We will report back to you about what you have said and what we plan to do about it. 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

Integrity	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You maintain strong relationships with others.
You demonstrate honesty and truthfulness at all times.
You foster a high standard of ethics and integrity.
You do what was promised.
You accept responsibility for mistakes.
Professional Development	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You allow employees to fully participate in employee training and professional development.
You demonstrate enthusiasm and a willingness to learn new skills and knowledge
You seek opportunities for continuous learning.
You encourage employees to take courses relevant to their job.
You seek opportunities for professional development.
Persuasion and Influence	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You persuade others to consider alternative points of view.
You develop a good rapport with others.
You are able to express own goals and needs.
You have excellent influencing/negotiating skills.
You ensure stakeholders are involved in the decision making process.
Innovation	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You create a safe environment for idea-sharing.
You suggest new ideas at meetings.
You encourage open communication to ensure that all proposals are considered.
You challenge current procedures to develop other alternatives.
You build upon the ideas and solutions of others.
Achievement	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You set high standards in your performance
You demonstrate a well-organized and timely approach to achieve desired results
You systematically work to improve the organization
You schedule time for self and others to optimize high priority and long term actions. Monitors progress towards business goals.
You complete work to a high technical standard
Technical	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You are naturally sought out by people outside your particular area for advice and opinion on a broad range of matters - not necessarily solely legal advice.
You willingly share your technical expertise; sought out as resource by others
You are knowledgeable of procedures or systems necessary for the job.
You willingly share information and expertise; sought out as resource by others
You know how to produce high quality products/work.
Excellence	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You demonstrate the functional or technical skills necessary to do your job.
You are planful and organized.
You take a lot of pride in your work.
You keep yourself and others focused on constant improvement.
You demonstrate the analytical skills to do your job.
Empowering Others	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You set clear goals for others to accomplish.
You provide support and resources needed to accomplish goals.
You distribute the workload to subordinates.
You encourage employees to solve problems on your own.
You avoid micromanaging your employees.
Coaching	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You coach employees in how to strengthen knowledge and skills to improve work performance.
You address employee behavior problems effectively.
You help employees to maintain high personal standards.
You meet regularly with employees to coach them on areas that will enhance your performance
You provide clear, motivating, and constructive feedback.
Planning	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You work in an organized manner
You anticipate potential challenges, develops plan to overcome them and then carries out the plan.
You are able to identify the needs of the department before a major change.
You are able to look ahead (beyond the present) when addressing the work/needs of the department.
You anticipate obstacles and ways to overcome them.

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

    5- Very Effective 4- Effective 3- Neither 2- Ineffective 1- Very Ineffective

    
    
52. Describe the greatest strengths of this person with regard to his/her overall effectiveness in performing his/her current responsibilities.
    
    
    
53. Describe the most important things this person could improve upon in order to increase his/her overall effectiveness in performing his/her current responsibilities.
    
    
    
54. Additional comments, if any for [Participant Name Here]'s assessment.