Objectives - 360 Degree Feedback Survey Sample #1





360-Degree Feedback Survey

Questionnaires Measuring Objectives:
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)
Instructions for Employees Participating in the 360-Feedback Assessment:

[Company] is conducting a 360-Degree Feedback Assessment developed by HR-Survey for selected managers.

You have been selected to receive feedback from a group of others. As part of this process, you will need to complete a self-assessment questionnaire at this time. Your feedback is an important part of our company's leadership development process and this survey 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 questions below, think about your experiences over the last 12 months. The effectiveness of this development tool is dependent on your honest, forthright and constructive responses so please bear this in mind as you answer each question. Your responses will be combined with the responses received from others and a report will be generated for you to foster growth and on-going 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.

Sample Result Document:
Sample Results
Your feedback is valuable in helping the individual to understand how they are perceived and experienced by others and the impact their behavior has on people in the organization with whom they interact. Feedback received also acknowledges strengths and identifies areas for development.

Use the form below to provide your feedback. Each field and comment box requires a response before you can SUBMIT your final feedback.

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

Thank you for your participation in the survey. We look forward to seeing the analysis of your responses and we are hoping for 100% participation.

Management Team


Objectives

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You set long-term and short-term goals.
  1. You consistently provide me with timely feedback for improving my performance.
  1. You encourage others to take on greater responsibility.
  1. You work toward achieving established goals and objectives.
  1. You effectively organize resources and plans
If you were to make improvements in Objectives, what are your suggestions for how you can improve this?

Creativity

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You create a lot of new ideas.
  1. You conceive, implement and evaluate ideas.
  1. You add value to the department/organization.
  1. You develop solutions to challenging problems.
  1. You are creative and inspirational.
If you were to make improvements in Creativity, what are your suggestions for how you can improve this?

Bias for Action

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You convey a sense of urgency about addressing problems and opportunities
  1. You display high energy and enthusiasm on consistent basis.
  1. You coach others to foster an environment which can adapt quickly and willingly to rapid change.
  1. You encourage risk taking and experimentation to improve performance
  1. You identify ways to simplify work processes and reduce cycle times
If you were to make improvements in Bias for Action, what are your suggestions for how you can improve this?

Emotional Intelligence

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You help to make decisions and solve problems using knowledge about how others will react in certain situations.
  1. You are able to understand others' points of view.
  1. You accurately perceive the emotional reactions of others.
  1. You are able to express yourself clearly.
  1. You help employees to resolve conflicts, communicate clearly, and work together to solve problems.
If you were to make improvements in Emotional Intelligence, what are your suggestions for how you can improve this?

Performance

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You have great overall performance
  1. You work effectively in the department.
  1. You are able to organize work.
  1. You set a high standard for job performance.
  1. You are effective in performing your job.
If you were to make improvements in Performance, what are your suggestions for how you can improve this?

Decision Making

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You are firm in your decision and not easily influenced by the whims of others.
  1. I am able to learn from my mistakes.
  1. I am open to listening to others who may have different ideas.
  1. I am creative about the decisions I make.
  1. You do not lose sight of the big picture when making decisions
If you were to make improvements in Decision Making, what are your suggestions for how you can improve this?

Initiative

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. I am proactive and get things done.
  1. I capitalize on opportunities as they become available.
  1. I update the documentation as soon as the situation changes.
  1. You guide strategic initiatives to advance the department/organization.
  1. I act quickly when a small problem arises to keep it from becoming a major issue.
If you were to make improvements in Initiative, what are your suggestions for how you can improve this?

Regulatory/Compliance

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You create documents and reports as needed to maintain compliance with regulations.
  1. I create necessary compliance policies and procedures.
  1. I develop regulatory compliance strategies.
  1. I develop compliance reports to share with stakeholders.
  1. I implement internal control processes to detect misconduct or patterns of illegal transactions.
If you were to make improvements in Regulatory/Compliance, what are your suggestions for how you can improve this?

Business Acumen

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. I incorporate innovative approaches and being adaptable to change.
  1. I understand cash flow procedures and statements.
  1. I recognize trends in underlying data.
  1. I involve key stakeholders (employees, customers, investors, partners) in the planning process to gain diverse perspectives and buy-in.
  1. You understand the costs, profits, markets, and added value of issues.
If you were to make improvements in Business Acumen, what are your suggestions for how you can improve this?

  1. What are [Participant Name Here]'s greatest strengths demonstrated this year?


  2. What are [Participant Name Here]'s areas for development?


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