Leadership - 360 Degree Feedback Survey Sample #8

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)

You have been selected to provide feedback for the manager listed above. Your feedback is an important part of 's leadership development process. This tool is intended to gather broad feedback in the core competencies and role responsibilities that are important for the on-going success of our organization.

In responding to the assessment form, please think about your experiences working with this individual during the last six to twelve months. Your responses will be merged with other people's feedback and presented to to guide them in their on-going development. Comments will be shared anonymously, as written, with the manager.

Sample Result Document:
Sample Results
Method of use: As part of the review process, managers will receive feedback from peers and staff. It is recognized that not all participants will be able to assess an individual's performance in all areas. The feedback received will be utilized as input to the manager's performance and on-going development plan.

You may sign out at any time by pressing the Save button at the end of the form and then closing your browser. You may return later to pick up where you left off. When you are done, press the Complete button.

When clicking your selection below, try to best fit the manager's actual behaviors to the scale provided.

If you are not sure, or unable to assess, select "Not Applicable" (N/A) option.

Please complete your response by .


Agree Unsure Disagree N/A
  1. Sets clear goals and objectives for subordinates.
  1. Motivates others to reach and exceed organizational goals and objectives.
  1. Demonstrates leadership and courage in critical situations.
  1. Motivates and challenges employees to attain a shared vision.
  1. Gives direct, constructive, and actionable feedback.

Persuasion and Influence

Agree Unsure Disagree N/A
  1. Able to express own goals and needs.
  1. Communicates effectively with others.
  1. Seeks to obtain consensus or compromise.
  1. Attempts to persuade others rather than simply control them.
  1. Understanding what others need.


Agree Unsure Disagree N/A
  1. Reflects on what is working and what could be improved.
  1. Encourages others to produce the highest quality work products.
  1. Holds employees accountable for their quality of work.
  1. Encourages employees to produce the best quality products.
  1. Analyze what occurred and re-adjusts accordingly when goals are not met.

Change Management

Agree Unsure Disagree N/A
  1. Assists others in understanding changes to the organization.
  1. Addresses organizational and departmental resistance to changes.
  1. Works cooperatively with others to implement changes.
  1. Effective in implementing new organizational vision and values.
  1. Effective in dealing with ambiguous and challenging situations.

Empowering Others

Agree Unsure Disagree N/A
  1. Distributes the workload to subordinates.
  1. Is confident in the abilities of employees assigned important tasks.
  1. Is aware of the skill levels of employees and assigns tasks that are at the appropriate skill level.
  1. Trusts employees are able to complete assigned tasks.
  1. Gives employees the opportunity to make their own decisions at work.


Agree Unsure Disagree N/A
  1. Supports and encourages relationships that are created by diverse team members.
  1. Maintains infrastructure to support partnerships and networks.
  1. Capitalizes on partnerships and networks to enhance the Company's bottom line.
  1. Supports a partnering/networking culture.
  1. Forges mutually beneficial relationships between individuals with diverse backgrounds.

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

  2. Strengths

  3. Areas for Development

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