Interpersonal Skills - 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

Interpersonal Skills	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You value the opinions of others.
You are open and approachable
You are able to work with individuals at all levels of the company.
You create an atmosphere that supports the open expression of ideas
You use tact, compassion, and sensitivity in interactions with others.
Passion To Learn	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You demonstrate through personal behavior the commitment to high standards of performance.
You recognize own areas for development and consciously seek assignments that will provide practice in areas of developmental need.
You are motivated by the desire to be "the best".
You hold self and associates accountable for goal achievement.
You take initiative for own learning and development.
Attitude	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You contribute to a positive work environment.
You contribute to a positive and fun work environment.
You are gracious and professional in your interactions with others.
You work to eliminate unnecessary work or barriers that get in others' way.
You treat all people fairly and with respect.
Time Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You leave time in the schedule for unplanned contingencies.
You set a good balance between work and family life.
You complete tasks ahead of schedule.
You complete high-priority work within required timelines.
You use agendas when chairing or facilitating meetings.
Achievement	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You make a plan for getting things done and drives execution of the strategic plan, actively supporting or leading initiatives to closure.
You accept setbacks and challenges as improvement opportunities
You complete work to a high technical standard
You follow-up and take action when goals are not met to ensure better results in the future.
You systematically work to improve the organization
Technical	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You demonstrate mastery of the technical competencies required in your work.
You willingly share information and expertise; sought out as resource by others
You willingly share your technical expertise; sought out as resource by others
You know how to produce high quality products/work.
You keep current with technical advances within your professional discipline; embrace and apply new techniques and practices
Managing Risk	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You recognize that small changes may snowball into major events.
You respond appropriately to unexplained or unanticipated events.
You seek to retain the best and brightest employees.
You maintain open communication with other departments.
You know how to obtain desired results with minimal losses.
Trustworthy	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You build and maintain the trust of others.
You are a person others can count on.
You work in a way that makes others want to work with you.
You are trustworthy; is someone that can be trusted.
You communicate an understanding of the other person's interests, needs and concerns.
Negotiation	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You are able to decline bad ideas to avoid making poor decisions.
You are flexible in responses.
You are able to clearly express thoughts and concerns.
You maintain good interpersonal relationships with representatives from the other party.
You conduct necessary preparations before engaging in negotiations.
Strategic Focus	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You understand and contribute to development of strategic goals.
You monitor performance of each market within the Area, utilizing reports to ensure sales growth, cost management, and profitability targets are met.
You create plans to develop and promote organizational and area strengths, as well as to address weaknesses.
You understand your role within the organization.
You look for opportunities to enhance contributions to the bottom line.
Planning	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You anticipate obstacles and ways to overcome them.
You delegate role to team members to accomplish goals.
You work in an organized manner
You are able to look ahead (beyond the present) when addressing the work/needs of the department.
You are able to identify the needs of the department before a major change.

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

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

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