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)
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.

Competencies Included:
Interpersonal Skills, Self Management, Feedback, Management, Persuasion and Influence, Problem Solving, Objectives, Client Focus, Co-worker Development, Company
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. I appreciate the extra efforts made by coworkers.
  1. I respect other members of the team/department.
  1. I maintain a high degree of honesty and integrity.
  1. I follow up on inquiries in a timely manner.
  1. You assist those in the department who need help in meeting performance metrics.
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 analyze own reactions on the spot to ensure that communication does not appear to be driven by anger.
  1. You consciously control own negative emotions in order to keep team morale up.
  1. You are aware of personal impact on others and adjusts behavior to create a positive leadership presence.
  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.
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 are visible and approachable.
  1. You accept the views of others.
  1. You are easy to approach with ideas and opinions.
  1. You consider other's opinion and suggestions.
  1. You seek feedback to enhance performance.
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 are ready to offer help
  1. You take responsibility for things that go wrong
  1. You make others feel enthusiastic about your work
  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 attempt to persuade others rather than simply control them.
  1. You persuade others to consider alternative points of view.
  1. You communicate effectively with others.
  1. You understand what others need.
  1. You seek to obtain consensus or compromise.
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 understand the root causes of problems.
  1. You can develop innovative solutions to problems.
  1. You are a good problem solver and decision maker
  1. You identify fresh approaches and shows a willingness to question traditional assumptions.
  1. You make judgments based upon relevant information.
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 organize and schedules events, activities, and resources.
  1. You consistently provide me with timely feedback for improving my performance.
  1. You work toward achieving established goals and objectives.
  1. You communicate goals and objectives to employees.
  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. You consistently demonstrate a client focus.
  1. You manage client accounts with high degree of competence.
  1. You received good feedback from clients.
  1. You put client's needs first.
  1. You prioritize the needs and preferences of the client.
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 take immediate action on poor performance
  1. You provide ongoing feedback to co-workers on your development progress
  1. You set and clearly communicate expectations, performance goals, and measurements to others
  1. You give others development opportunities through project assignments and increased job responsibilities
  1. You work to identify root causes of performance problems
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 understand the "basics" as to how [Company] functions/operates.
  1. You understand how decisions impact other business units beyond your immediate department of work group.
  1. You understand the use of [Company] products and services.
  1. You impress upon others the important aspects of [Company].
  1. You attend [Company] gatherings and social events.
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.