Managing Performance - 360 Degree Feedback Survey Sample #8

Questionnaires Measuring Managing Performance:
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)
Self-Assessment Instructions

You have been selected to complete a self-assessment questionnaire as part of a 360-degree feedback assessment. 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.

Respond to the assessment form based on your work experiences during the previous 12 months. Your responses will be merged with other people's feedback and presented to you in your on-going development. Comments from others will be shared anonymously, as written.

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 .

Managing Performance

Agree Unsure Disagree N/A
  1. You prioritize the work of others.
  1. You set and maintain high standards for self and others.
  1. You are consistent in disciplinary/corrective actions.
  1. You use timely and appropriate corrective/disciplinary actions.
  1. You set long and short term goals.


Agree Unsure Disagree N/A
  1. You take risks to advance important ideas.
  1. You foster a creative and innovative work environment.
  1. You find creative ways to get things done with limited resources.
  1. You solve problems with insight and understanding.
  1. You develop new products and services.

Continual Learning

Agree Unsure Disagree N/A
  1. You pursue professional development opportunities when they arise.
  1. You take charge of your training and skills enhancement.
  1. You improve on your skill sets.
  1. You set relevant learning objectives and goals.
  1. You build on your strengths while addressing your weaknesses.


Agree Unsure Disagree N/A
  1. You ask others for their ideas and opinions.
  1. You actively seek feedback from others.
  1. You are open to the suggestions of others.
  1. You are visible and approachable.
  1. You accept the views of others.


Agree Unsure Disagree N/A
  1. You contribute to a positive and fun work environment.
  1. You contribute to a positive work environment.
  1. You work to eliminate unnecessary work or barriers that get in others' way.
  1. You show by your actions that you trust in the positive intentions of others.
  1. You build open and trusting relationships.

Cultural Awareness

Agree Unsure Disagree N/A
  1. You seek out different viewpoints and benefits from different perspectives.
  1. You show respect in daily interactions
  1. You value the opinions of diverse groups and individual.
  1. You respect others regardless of age, race, gender, nationality, or disability.
  1. You maintain an inclusive work environment that maximizes the talents of others in achieving goals.

Time Management

Agree Unsure Disagree N/A
  1. You keep and maintain a To-Do list.
  1. You focus on tasks that have high priority.
  1. You use agendas when chairing or facilitating meetings.
  1. You complete high-priority work within required timelines.
  1. You leave time in the schedule for unplanned contingencies.

Commitment To Result

Agree Unsure Disagree N/A
  1. You encourage commitment in others to obtain results.
  1. You take immediate action toward goals.
  1. You create a sense of urgency among the store team members to complete activities, which drive sales.
  1. You are able to focus on a task even when working alone.
  1. You convey strong sense of own pride in Company to associates by creating a shared vision around sales and customer service.


Agree Unsure Disagree N/A
  1. You assure [Company] principles are understood, employed & pursued.
  1. You consistently provide me with timely feedback for improving my performance.
  1. You communicate goals and objectives to employees.
  1. You effectively organize resources and plans
  1. You work toward achieving established goals and objectives.

Client Focus

Agree Unsure Disagree N/A
  1. You look for opportunities that have a positive impact on Clients.
  1. You ensure client commitments and requirements are met or exceeded
  1. You form strong client relationships
  1. You satisfy client needs.
  1. You are pro-active in dealing with clients and addressing your needs.

Customer Focus

Agree Unsure Disagree N/A
  1. You ensure all customer commitments and requirements are met or exceeded.
  1. You maintain positive customer relationships.
  1. You consider customers point of view when making decisions.
  1. You consistently model positive customer service attitudes.
  1. You develop good rapport and trust with the customer.

Fiscal Management

Agree Unsure Disagree N/A
  1. You provide budgeting and accounting support to the Company.
  1. You monitor spending.
  1. You effectively manage appropriations, reporting, purchases, expenditures, payrolls, and staff.
  1. You develop of the department's annual budget.
  1. You keep excellent records for financial transparency.

  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.