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 do what was promised.
You demonstrate honesty and truthfulness at all times.
You foster a high standard of ethics and integrity.
You follow tasks to completion.
Professional Development	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You encourage employees to take courses relevant to their job.
You seek opportunities for continuous learning.
You seek opportunities for professional development.
You quickly acquire and apply new knowledge and skills when needed
You keep yourself up-to-date of technical/professional issues
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 attempt to persuade others rather than simply control them.
You communicate effectively with others.
You understand what others need.
Innovation	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You challenge current procedures to develop other alternatives.
You develop new products and services.
You build upon the ideas and solutions of others.
You search for opportunities and innovative ways to improve the organization.
You encourage open communication to ensure that all proposals are considered.
Achievement	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You demonstrate improvement in performance.
I create impactful reports for the re-organization committee.
You complete work to a high technical standard
You establish stretch goals to advance skills and output.
You successfully complete the orientation training program.
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 use expertise to identify issues and think through creative solutions to get a problem solved or objective accomplished.
You seek information from others as needed.
You keep current with technical advances within your professional discipline; embrace and apply new techniques and practices
You willingly share your technical expertise; sought out as resource by others
Excellence	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You produce high quality work.
You keep yourself and others focused on constant improvement.
You demonstrate the functional or technical skills necessary to do your job.
You demonstrate the analytical skills to do your job.
You take a lot of pride in your work.
Empowering Others	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You encourage others to obtain necessary skills and training.
I encourage employees to make informed decisions based on their own judgment and reasoning.
I recognize and reward employees who make important decisions and take action when necessary.
I help employees advance their skills so that they can have more autonomy.
I allow employees the opportunity to take time off when needed.
Coaching	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You meet regularly with employees to coach them on areas that will enhance your performance
You provide clear, motivating, and constructive feedback.
You develop the skills and capabilities of others.
You conduct regular performance appraisals and feedback.
You coach employees in how to strengthen knowledge and skills to improve work performance.
Planning	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I can effectively use logistics planning to reduce supply delays.
You are able to balance the needs of multiple stakeholders in developing the plan for the division.
You understand the process for developing strategic plans for the organization.
I can develop a detailed plan outlining tasks, resources, timelines, and deliverables.
You set the appropriate sequence of tasks to efficiently achieve the goal.

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.