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

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Interpersonal Skills	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I pay close attention to what is being communicated verbally and nonverbally.
You value the opinions of others.
I take time to recognize the efforts of others.
I consider the other individual's point of view.
You communicate initiatives in a clear and actionable manner to employees.
Passion To Learn	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You exhibit willingness to upgrade skills through additional training and education.
You take initiative for own learning and development.
You are committed to enhancing your own knowledge and skills.
You are open to feedback from others.
You demonstrate a willingness to participate in continuing education courses.
Attitude	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You contribute to a positive and fun work environment.
You visibly support and encourages diversity in style and background.
You build open and trusting relationships.
You contribute to a positive work environment.
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
I focus time on the tasks that yield the highest value.
I avoid distractions from personal phone or other personal devices.
I allow for time buffers between tasks so that the schedule does not become delayed due to unforeseen circumstances.
I persist with crucial assignments.
You set a good balance between work and family life.
Achievement	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You establish Specific Measurable Achievable Realistic and Timed (SMART) goals.
I am able to reduce department expenses by 25 percent.
You make a plan for getting things done and drives execution of the strategic plan, actively supporting or leading initiatives to closure.
You strive to meet goals and objectives.
You demonstrate a well-organized and timely approach to achieve desired results
Technical	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
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.
You seek information from others as needed.
You use expertise to identify issues and think through creative solutions to get a problem solved or objective accomplished.
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 are knowledgeable of standard risk management principles.
You track risks in a project.
You use risk management to make better strategic decisions.
I establish roles, responsibilities, procedures.
I determine the impact of specific risks on infrastructure.
Trustworthy	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You take ownership, deliver on commitments
You are a person others can count on.
You are trustworthy; is someone that can be trusted.
You demonstrate congruence between statements and actions.
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
I clearly communicate boundaries and the reasons behind them.
You effectively set the tone and agenda, create rapport, and build momentum at the start of negotiations.
I engage in questioning to obtain necessary information and examine various alternatives.
You adjust methods to suit the current situation.
I stay well-informed about the issues and priorities.
Strategic Focus	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You make quick and creative decisions to adjust the strategy to meet the demands of changing situations.
You align projects to the strategic goals of the company.
I create innovative strategies.
You create plans to develop and promote organizational and area strengths, as well as to address weaknesses.
I create a vision for the organization based on how the organization should appear in the future.
Planning	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You delegate role to team members to accomplish goals.
You set up and monitor timeframes and plans
I make strategic and tactical decisions to guide the logistics process.
I can initiate the planning process by defining the scope of the project.
You are able to look ahead (beyond the present) when addressing the work/needs of the department.

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.