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
I am honest about making mistakes and willing to fix them.
I am transparent and honest in communications, intentions, and actions.
I demonstrate positive behaviors for others to follow.
You effectively manage conflicts by dealing with them directly and immediately
I demonstrate a high degree of ethics and integrity in the workplace.
Passion To Learn	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You are open minded and curious about learning new skills.
You hold self and associates accountable for goal achievement.
You are committed to enhancing your own knowledge and skills.
You inspire others to learn new things.
You recognize own areas for development and consciously seek assignments that will provide practice in areas of developmental need.
Attitude	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You are gracious and professional in your interactions with others.
You build open and trusting relationships.
You contribute to a positive work environment.
You treat all people fairly and with respect.
You work to eliminate unnecessary work or barriers that get in others' way.
Time Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You optimize time management through automation.
You encourage colleagues to spend more time on work related activities.
I consistently meet the project schedule.
You are productive for the majority of time spent during the day.
I am never late for work.
Achievement	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You establish Specific Measurable Achievable Realistic and Timed (SMART) goals.
I take calculated risks to achieve difficult goals.
You hold others to high standards of achievement.
You set challenging goals for the department.
I increase revenue for the company.
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 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.
Managing Risk	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I minimizes operational setbacks and delays.
You use risk management to remain in compliance with regulations.
You identify and mitigate risks while making informed, strategic decisions.
I decide what actions will be taken.
You seek to increase safety in the workplace.
Trustworthy	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You demonstrate congruence between statements and actions.
You take care to maintain confidential information.
You build and maintain the trust of others.
You take ownership, deliver on commitments
You consistently keep commitments.
Negotiation	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You influence others through rational argument and persuasion.
You are able to control your emotional responses and correctly gauge the emotions of others.
You demonstrate emotional stability to facilitate productive problem-solving and relationship building.
I foster a robust, collaborative setting; sets clear expectations; and introduces an agenda that matches priorities.
You are able to say "no" when it is essential to maintaining quality and high standards.
Strategic Focus	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I develop strategies that are practical and can be feasibly implemented within a reasonable period of time.
You exhibit a strategic orientation to identify and capitalize on opportunities to advance the organization.
You focus efforts on specific marketing strategies.
You create deadlines for various components of the strategy.
You are able to decline a poor strategy by proposing alternate strategies.
Planning	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I am good at planning for the "unexpected".
I set the appropriate sequence of tasks to ensure completion of the project.
You anticipate potential challenges, develops plan to overcome them and then carries out the plan.
I can create a timeline for events and monitors progress.
I can initiate the planning process by defining the scope of the project.

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.