Leadership - 360 Degree Feedback Survey Sample #5

360-Degree Assessment Survey

Dear Employee:

Thank you for participating in a 360-degree feedback assessment. In this process, you will complete a self-assessment questionnaire (below). You will also receive feedback from others including your manager, peers and direct reports. As you respond, please respond using just your experiences in the past 12 months. Rate each item using the scale shown. Comments can be very helpful; at a minimum where you give a particularly high or low rating, please share your reasons in the Closing Comments section. Your responses will be compiled with feedback from others and presented to you at the conclusion of this assessment to help guide your ongoing professional development.

Partially completed forms can be saved by using the Save/Still Working button at the bottom of the page. You may return at a later time to complete/edit the form. Your saved responses will be shown each time you re-visit the feedback form. When you are certain that you have completed your responses and will be not making any changes, click the Complete button.

Please ensure that your submission is made by .

Thank you for your participation in the survey.

Management Team

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Leadership	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You hold others accountable for your actions.
You guide decision-making by coaching, counseling and rewarding.
You effectively lead others.
You act decisively in implementing decisions.
You motivate and challenges employees to attain a shared vision.
Juggling Multiple Responsibilities	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You plan and organize continuously while performing all other responsibilities and activities.
You organize tasks for the most efficient order of completion.
You ensure that assignments are prioritized according to the needs of the department/company.
You keep track of multiple assignments and deadlines.
You determine which tasks are critical and which tasks are optional.
Trustworthy	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You are trustworthy; is someone that can be trusted.
You take care to maintain confidential information.
You take ownership, deliver on commitments
You communicate an understanding of the other person's interests, needs and concerns.
You demonstrate a sense of responsibility and commitment to public trust.
Responsible	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Your behavior is ethical and honest.
You hold yourself accountable to goals / objectives
You complete assigned work tasks.
You take personal responsibility for results.
You set a good example
Coaching	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You meet regularly with employees to coach them on areas that will enhance your performance
You develop the skills and capabilities of others.
You address employee behavior problems effectively.
You help employees to maintain high personal standards.
You conduct regular performance appraisals and feedback.
Business Acumen	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You have a good understanding of business operations to more effectively align company services to meet the needs of its customers.
I recognize the individual needs of customers.
I assist others in better understanding the company's operations, goals, and strategic challenges.
You effectively troubleshoot customer business issues.
You ask the 'right' questions to size up or evaluate situations.
Strategic Insight	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You ensure that the department's goals are strategically aligned with the company's goals.
You identify potential problems before they become critical incidents.
You create a mission statement describing the purpose for the organization.
You ommunicate with employees to find out their needs.
You have conversations with customers and clients to get a better insight into their personal needs.
Fiscal Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You develop budgets and plans for various programs and initiatives.
You monitor expenses and verify the need for items purchased.
You monitor spending.
You provide budgeting and accounting support to the Company.
You are effective in using company's resources.
Global Perspective	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You collaborate with others respectfully and effectively with other people regardless of differences in cultural backgrounds.
You apply knowledge of overseas markets.
You work well with others from different cultural backgrounds.
You are comfortable using teleconferencing equipment to facilitate meetings with others abroad.
You consider customers point of view when making decisions.

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

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

    
    
47. Strengths
    
    
    
48. Areas for Development
    
    
    
49. Please give any final comments or suggestions for [Participant Name Here]'s assessment.