Managing Risk - 360 Degree Feedback Survey Sample #8

Questionnaires Measuring Risk Management:
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 .

Managing Risk

Agree Unsure Disagree N/A
  1. Perceives the risks of different work tasks and activities.
  1. Develops policies to address risk situations in the workplace.
  1. Aware of appropriate actions to minimize risks.
  1. Committed to implementing rules and procedures to minimize risk.
  1. Is concerned about process safety management.


Agree Unsure Disagree N/A
  1. Accepts accountability for their actions and results.
  1. Holds team accountable to meeting goals.
  1. Can be counted on to do what they say they are going to do.
  1. Defines roles, rights, and responsibilities of the team.
  1. Defines roles, rights, and responsibilities of employees.

Juggling Multiple Responsibilities

Agree Unsure Disagree N/A
  1. Plans and organizes continuously while performing all other responsibilities and activities.
  1. Builds in extra time in the schedule for unplanned events/occurrences.
  1. Determines which tasks are critical and which tasks are optional.
  1. Ensures that assignments are prioritized according to the needs of the department/company.
  1. Coordinates the work of a team by assigning tasks to other team members.


Agree Unsure Disagree N/A
  1. Goal Setting
  1. Makes sure that I have a clear idea of our group's goals.
  1. Achieves goals.
  1. Understands & contributes to development of strategic goals.
  1. Establishes and documents goals and objectives.

Commitment To Result

Agree Unsure Disagree N/A
  1. Coordinates all department activities into a cohesive team effort.
  1. Able to focus on a task even when working alone.
  1. Conveys strong sense of own pride in Company to associates by creating a shared vision around sales and customer service.
  1. Maintains persistence and dedication to achieving results.
  1. Encourages commitment in others to obtain results.

Interpersonal Skills

Agree Unsure Disagree N/A
  1. Demonstrates compassion and understanding of others.
  1. Effectively manages conflicts by dealing with them directly and immediately
  1. Builds a strong rapport with co-workers.
  1. Able to work with individuals at all levels of the Company.
  1. Creates an atmosphere that supports the open expression of ideas


Agree Unsure Disagree N/A
  1. Behavior is ethical and honest.
  1. Is a person you can trust.
  1. ...takes personal responsibility for results.
  1. Works in a way that makes others want to work with her/him.
  1. Sets a good example.


Agree Unsure Disagree N/A
  1. Coaches employees in how to strengthen knowledge and skills to improve work performance.
  1. Conducts regular performance appraisals and feedback.
  1. Helps employees to understand responsibilities, authority, and expectations.
  1. Meets regularly with employees to coach them on areas that will enhance their performance
  1. Provides clear, motivating, and constructive feedback.

Cultural Awareness

Agree Unsure Disagree N/A
  1. Recognizes individual and cultural differences.
  1. Seeks opportunities to learn about the other cultural backgrounds of colleagues.
  1. Seeks knowledge and information about other cultures.
  1. Fosters a diverse workforce free from discrimination and harassment.
  1. Open to learning about different cultures.


Agree Unsure Disagree N/A
  1. ...treats others with respect and dignity.
  1. Treats others with respect and dignity.
  1. Works effectively with people from other departments.
  1. Includes others in the decision making processes.
  1. Able to see issues from others' perspectives.

  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.