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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.

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.
Edit this Survey
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Interpersonal Skills

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. I value the input from coworkers.
  1. I promote acceptance of diverse viewpoints from team members.
  1. You are respectful of the opinions and ideas of others.
  1. You anticipate the concerns of other employees.
  1. I follow up on inquiries in a timely manner.
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 are aware of personal impact on others and adjusts behavior to create a positive leadership presence.
  1. You consciously control own negative emotions in order to keep team morale up.
  1. You use patience and self-control in working with customers and associates.
  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 seek feedback to enhance performance.
  1. You consider other's opinion and suggestions.
  1. You accept the views of others.
  1. You are easy to approach with 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 are ready to offer help
  1. You set an example for others to follow
  1. You keep staff informed about what is happening in the company
  1. You delegate tasks effectively
  1. You take responsibility for things that go wrong
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 are able to express own goals and needs.
  1. You seek to obtain consensus or compromise.
  1. You ensure stakeholders are involved in the decision making process.
  1. You communicate effectively with others.
  1. You have excellent influencing/negotiating skills.
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 develop innovative solutions to problems.
  1. I am able to conduct a thorough Critical Incident interview.
  1. You are a good problem solver and decision maker.
  1. You encourage the sharing of information, concerns, and ideas to prevent problems from being overlooked.
  1. You gather input from staff for use in problem solving.
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 set long-term and short-term goals.
  1. You establish goals and objectives.
  1. You assure [Company] principles are understood, employed & pursued.
  1. You are able to organize work.
  1. You work toward achieving established goals and objectives.
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 follow up with any unanswered questions from the client.
  1. You create high quality products for the clients.
  1. You are aware of the client's needs.
  1. You deliver on commitments made to clients.
  1. You use client feedback to help improve products and services.
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 work to identify root causes of performance problems
  1. You give others development opportunities through project assignments and increased job responsibilities
  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 understand the "basics" as to how [Company] functions/operates.
  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 use of [Company] products and services.
  1. You follow existing procedures and processes.
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.