Leadership - 360 Degree Feedback Survey Sample #3





Questionnaires Measuring Leadership:
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)
Instructions

You have been asked to evaluate yourself as part of a 360-degree feedback process. Other employees, including your manager(s), peers, and direct reports will also evaluate you. In this manner, you will be provided with a comprehensive, multi-perspective (i.e., 360-degree) view of your performance as a manager. The objective is to provide you with feedback so as to allow you to improve your performance, resulting in improved team performance, and organizational effectiveness.

If you are not able to respond to an item, leave it blank and go on to the next item.

Sample Result Document:
Sample Results
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.

Please ensure that your submission is made between . The survey will only be available during these dates.







Leadership

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Encourages dialogue to clarify decision making and inform staff
  1. Sets a high level of performance expectations and challenges others to do the same.
  1. Communicates calmly and honestly even when stressed.
  1. Recognizes individual and team accomplishments and reward them appropriately.
  1. Demonstrates leadership and courage in critical situations.
Please feel free to provide any comments to help explain your answers?

Persuasion and Influence

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Develops a good rapport with others.
  1. Communicates effectively with others.
  1. Attempts to persuade others rather than simply control them.
  1. Seeks to obtain consensus or compromise.
  1. Understanding what others need.
Please feel free to provide any comments to help explain your answers?

Quality

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Encourages others to produce the highest quality work products.
  1. Implements quality control feedback loops to enhance services and products.
  1. Communicates quality standards that are easily by employees.
  1. Reflects on what is working and what could be improved.
  1. Encourages employees to produce the best quality products.
Please feel free to provide any comments to help explain your answers?

Initiative

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Seizes upon chances to improve the department's prospects.
  1. Acts quickly when a small problem arises to keep it from becoming a major issue.
  1. Acts independently to solve pressing needs.
  1. Immediately informs the supervisor of any critical incidents.
  1. Initiates draft reports for consideration.
Please feel free to provide any comments to help explain your answers?

Trustworthy

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Seeks to mitigate grievances by clarifying intentions and finding suitable remedies.
  1. Demonstrates congruence between statements and actions.
  1. Takes ownership, delivers on commitments
  1. Consistently keeps commitments.
  1. Is a person you can trust.
Please feel free to provide any comments to help explain your answers?

Self Management

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Deals with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
  1. Steps away from a situation to process appropriate response.
  1. Analyzes interpersonal problems instead of reacting to them.
  1. Sets an example for associates during stressful periods by maintaining a positive, can-do attitude.
  1. Does not allow own emotions to interfere with the performance of others.
Please feel free to provide any comments to help explain your answers?

Conflict Management

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Gets both sides to agree on a common framework.
  1. Seeks to remove misperceptions that may contribute toward conflict.
  1. Ensures that the basic needs of each party are satisfied.
  1. Able to persuade and influence others.
  1. Acknowledges each party's intrinsic needs.
Please feel free to provide any comments to help explain your answers?

Recognition

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Finds opportunities to recognize others.
  1. Is sincerely interested in the suggestions of co-workers
  1. Recognizes individuals for a specific outstanding achievement.
  1. Lets employees know when they have done well
  1. Reinforces and rewards employees for accomplishing necessary goals.
Please feel free to provide any comments to help explain your answers?

Others

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Treats others with respect and dignity.
  1. Includes others in the decision making processes.
  1. Helpful
  1. Is able to see issues from others' perspectives.
  1. Consistently demonstrates ability and willingness to trust others.
Please feel free to provide any comments to help explain your answers?

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






  2. Strengths


  3. Areas for Development


  4. Please give any final comments or suggestions for [Participant Name Here]'s assessment.