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 demonstrate compassion and understanding of others.
You create an atmosphere that supports the open expression of ideas
You adapt management style to meet the needs of the individual or situation.
You successfully resolve conflicts and grievances to a win-win solution.
You express appreciation of other's work.
Passion To Learn	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You are open to feedback from others.
You enjoy learning new skills and techniques.
You demonstrate a willingness to participate in continuing education courses.
You hold self and associates accountable for goal achievement.
You enhance your value to the company through additional training and development.
Attitude	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You treat all people fairly and with respect.
You are gracious and professional in your interactions with others.
You visibly support and encourages diversity in style and background.
You build open and trusting relationships.
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 do not procrastinate.
You complete tasks ahead of schedule.
You avoid distractions in the workplace.
You focus on tasks that have high priority.
You make time for developing plans and schedules.
Achievement	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You make use of talents of others to help achieve a high level of performance.
You strive to meet goals and objectives.
You establish stretch goals to advance skills and output.
You work at a quick pace to complete a high volume of work.
You strive to exceed standards of performance.
Technical	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You seek information from others as needed.
You demonstrate mastery of the technical competencies required in your work.
You keep current with technical advances within your professional discipline; embrace and apply new techniques and practices
You willingly share your technical expertise; sought out as resource by others
You willingly share information and expertise; sought out as resource by others
Managing Risk	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You track risks in a project.
You are concerned about process safety management.
You implement changes to reduce the chances of critical incidents in the future.
You seek to increase safety in the workplace.
You are aware of process safety management.
Trustworthy	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You take ownership, deliver on commitments
You seek to mitigate grievances by clarifying intentions and finding suitable remedies.
You are trustworthy; is someone that can be trusted.
You take care to maintain confidential information.
You deliver on promises made.
Negotiation	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You conduct necessary preparations before engaging in negotiations.
You are able to control your emotional responses and correctly gauge the emotions of others.
You are able to influence others to accept certain positions.
You actively listen to conversations to be able to recall important details later.
You are able to say "no" when necessary to effectively execute business strategy and meet long-term objectives.
Strategic Focus	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You monitor performance of each market within the Area, utilizing reports to ensure sales growth, cost management, and profitability targets are met.
You understand your role within the organization.
You sustain or achieves a competitive advantage for the organization by analyzing the best practices and lessons learned from other organizations.
You communicate goals and objectives to employees.
You focus attention on treating the causes of problems rather than simply addressing the symptoms.
Planning	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I develop plans to help manage expectations and project demands.
I conduct regular assessments of the project status to ensure adherence to the set schedule.
You involve relevant coworkers in the development of the plan.
I plan for how to allocate time to specific activities.
You have developed an effective strategic plan.

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.