Interpersonal Skills - 360 Degree Feedback Survey Sample #2





Questionnaires Measuring Interpersonal Skills:
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)
Survey 10 (Comment boxes only)
Survey 11 (Single rating per competency)
Survey 12 (Slide-bar scale)
Survey 13 (4-point scale; numbers; floating anchors)
Survey 14 (4-point scale; N/A)
Self-Assessment Instructions

You have been asked to complete a self-assessment questionnaire form (shown below). You will also receive feedback from others such as your peers, direct reports and manager. Feedback is an important part of our company's leadership development process and this survey 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 questions below, think about your experiences as an employee over the last twelve months and the goals you were asked to achieve. 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 become part of the assessment process to foster your growth and on-going development.

Sample Result Document:
Sample Results
Partially completed forms can be saved by using the Save/Still Working button at the bottom of the page. You may return at a later time to complete/edit the form. Your saved responses will be shown each time you re-visit the feedback form. When you are certain that you have completed your responses and will be not making any changes, click the Complete button.

Please ensure that your submission is made between . The survey will only be available during these dates.


Interpersonal Skills

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You successfully resolve conflicts and grievances to a win-win solution.
  1. You effectively manage conflicts by dealing with them directly and immediately
  1. I show appreciation for other's work.
  1. I consider the other individual's point of view.
  1. I am a highly respected individual in the company.
What are your suggestions for how you can make improvements
in Interpersonal Skills?

Self Management

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You set an example for associates during stressful periods by maintaining a positive, can-do attitude.
  1. You do not allow own emotions to interfere with the performance of others.
  1. You analyze interpersonal problems instead of reacting to them.
  1. You deal with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
  1. You step away from a situation to process appropriate response.
What are your suggestions for how you can make improvements
in Self Management?

Feedback

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You look to others for input.
  1. You are visible and approachable.
  1. You are easy to approach with ideas and opinions.
  1. You ask others for their ideas and opinions.
  1. You share past experiences with others as learning opportunities.
What are your suggestions for how you can make improvements
in Feedback?

Management

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You make others feel enthusiastic about your work
  1. You set an example for others to follow
  1. You are ready to offer help
  1. You delegate tasks effectively
  1. You keep staff informed about what is happening in the company
What are your suggestions for how you can make improvements
in Management?

Persuasion and Influence

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You ensure stakeholders are involved in the decision making process.
  1. You develop a good rapport with others.
  1. You seek to obtain consensus or compromise.
  1. You have excellent influencing/negotiating skills.
  1. You understand what others need.
What are your suggestions for how you can make improvements
in Persuasion and Influence?

Problem Solving

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You are able to solve problems at root cause rather than at symptom level.
  1. You generate alternative solutions to problems and challenges.
  1. You actively seek the root cause of a problem.
  1. You solve problems using logic and insight.
  1. You are effective in solving problems.
What are your suggestions for how you can make improvements
in Problem Solving?

Objectives

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You are able to organize work.
  1. You assure [Company] principles are understood, employed & pursued.
  1. You establish goals and objectives.
  1. You encourage others to take on greater responsibility.
  1. You set long-term and short-term goals.
What are your suggestions for how you can make improvements
in Objectives?

Client Focus

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. I identify opportunities that enhance the client's experience.
  1. I am competent in handling client cases.
  1. You demonstrate a commitment to client focus.
  1. I deliver customized solutions for each client.
  1. I make sure client needs are understood by the team members.
What are your suggestions for how you can make improvements
in Client Focus?

Co-worker Development

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You give others development opportunities through project assignments and increased job responsibilities
  1. You take immediate action on poor performance
  1. You work to identify root causes of performance problems
  1. You set and clearly communicate expectations, performance goals, and measurements to others
  1. You provide ongoing feedback to co-workers on your development progress
What are your suggestions for how you can make improvements
in Co-worker Development?

Company

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You express loyalty and dedication to [Company] in interactions with others.
  1. You understand how decisions impact other business units beyond your immediate department of work group.
  1. You understand the "basics" as to how [Company] functions/operates.
  1. You attend [Company] gatherings and social events.
  1. You understand the use of [Company] products and services.
What are your suggestions for how you can make improvements
in Company?


  1. Strengths


  2. Areas for Development


  3. Please give any final comments or suggestions for [Participant Name Here]'s assessment.