Others- 360 Degree Feedback Survey Sample #2





Surveys Measuring Others:
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

You have been selected to provide feedback on the employee listed above. 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 working with this employee over the last twelve months and the goals they were asked to achieve. 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 discussed with the employee to foster growth and on-going development.

Competencies Included:
Others, Adaptability, Self Management, Establishing Focus/Direction, Analytical, Problem Solving, Technology Use/Management, Business Acumen, Company
Sample Result Document:
Sample Results
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 between . The survey will only be available during these dates.


Others

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Consistently demonstrates ability and willingness to trust others.
  1. ...treats others with respect and dignity.
  1. Works effectively with people from other departments.
  1. Works across boundaries within the organization.
  1. Able to see issues from others' perspectives.
  1. Forms working relationships with employees from other departments.
What are your suggestions for how [Participant Name] can make improvements
in Others?

Adaptability

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Learns from personal experiences and/or mistakes.
  1. Responds quickly to new information.
  1. Is open to new ideas and innovations.
  1. Flexible and open to new ideas and encourages others to recognize the value of change.
  1. Adjusts priorities to the new Corporate mission.
  1. Is aware of changes to team personnel.
What are your suggestions for how [Participant Name] can make improvements
in Adaptability?

Self Management

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Is aware of personal impact on others and adjusts behavior to create a positive leadership presence.
  1. Steps away from a situation to process appropriate response.
  1. Deals with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
  1. Does not allow own emotions to interfere with the performance of others.
  1. Analyzes own reactions on the spot to ensure that communication does not appear to be driven by anger.
  1. Analyzes interpersonal problems instead of reacting to them.
What are your suggestions for how [Participant Name] can make improvements
in Self Management?

Establishing Focus/Direction

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Maintains self-control when personally criticized.
  1. Maintains focus when handling several problems or tasks simultaneously.
  1. Makes sure that employees understand and identify with the team's mission.
  1. Functions well under stress, deadlines, and/or significant workloads.
  1. Stays focused even when under pressure and stress.
  1. Excellent at managing time.
What are your suggestions for how [Participant Name] can make improvements
in Establishing Focus/Direction?

Analytical

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Analyzes data and information from several sources and arrives at logical conclusions.
  1. Actively seeks constructive feedback from others.
  1. Uses standard data collection practices.
  1. Uses a variety of data collection methods.
  1. Performs checks on data accuracy and quality.
  1. Determines important parameters or issues to take into account when solving problems.
What are your suggestions for how [Participant Name] can make improvements
in Analytical?

Problem Solving

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Solves problems that have difficult or conflicting constraints.
  1. Ability to develop innovative solutions to problems.
  1. Works cooperatively with others to solve problems.
  1. Identifies and assesses all potential responses to a problem.
  1. Evaluates alternative courses of action.
  1. Makes judgments based upon relevant information.
What are your suggestions for how [Participant Name] can make improvements
in Problem Solving?

Technology Use/Management

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Adopts the implementation of new technology into the workplace.
  1. Proficient in the use of technical systems and processes.
  1. Supports employee training and development initiatives regarding implementation of technology.
  1. Applies complex rules and regulations to maintain optimal system performance.
  1. Maximizes the use of new technology to deliver products and services.
  1. Identifies gaps between actual and needed technical competencies and provides recommendations for required training.
What are your suggestions for how [Participant Name] can make improvements
in Technology Use/Management?

Business Acumen

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Understands the costs, profits, markets, and added value of issues.
  1. Coach others to foster an environment which can adapt quickly and willingly to rapid change
  1. Seeks to better understand other areas of the company, including their operations, personnel, and output.
  1. Describes and summarizes data.
  1. Keeps informed of current income and expenses.
  1. Knows how to use financial information to make an impact on the organization.
What are your suggestions for how [Participant Name] can make improvements
in Business Acumen?

Company

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Supports [Company]'s marketing efforts.
  1. Maintains positive relationships between the [Company] and the community.
  1. Supports [Company]'s strategic objectives.
  1. Expresses loyalty and dedication to [Company] in interactions with others.
  1. Attends [Company] gatherings and social events.
  1. Understands the use of [Company] products and services.
What are your suggestions for how [Participant Name] can make improvements
in Company?


  1. Strengths


  2. Areas for Development


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