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)
Survey 13 (4-point scale; numbers; floating anchors)
Survey 14 (4-point scale; N/A)
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.

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. Supports the efforts of other employees in implementing solutions to problems.
  1. Works across boundaries within the organization.
  1. Respects the opinions of other employees.
  1. Helpful
  1. Consistently demonstrates ability and willingness to trust others.
  1. ...treats others with respect and dignity.
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. Is aware of changes to team personnel.
  1. Responds quickly to new information.
  1. Is flexible when dealing with changes.
  1. Works effectively with various personalities of team members.
  1. Adjusts plans as needed based on changing conditions.
  1. Adjusts plans to meet the needs of new constraints.
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. Sets an example for associates during stressful periods by maintaining a positive, can-do attitude.
  1. Uses patience and self-control in working with customers and associates.
  1. Consciously controls own negative emotions in order to keep team morale up.
  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.
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. Sets appropriate goals for employees.
  1. Maintains self-control when personally criticized.
  1. Functions well under stress, deadlines, and/or significant workloads.
  1. Excellent at managing time.
  1. Makes sure that employees understand and identify with the team's mission.
  1. Stays focused even when under pressure and stress.
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. Uses current data for decision making.
  1. Determines averages and trends in the data.
  1. Prioritizes various actions to be taken when solving a problem.
  1. Identifies deviations from stated goals and objectives.
  1. Able to project future data points based on historical data.
  1. Asks the "right" questions to size up or evaluate situations.
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. Evaluates alternative courses of action.
  1. Analyzes systems and processes for opportunities to gain efficiency.
  1. Solves problems using logic and insight.
  1. Identifies fresh approaches and shows a willingness to question traditional assumptions.
  1. Understands the root causes of problems.
  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. Maximizes the use of new technology to deliver products and services.
  1. Applies complex rules and regulations to maintain optimal system performance.
  1. Adopts the implementation of new technology into the workplace.
  1. Identifies gaps between actual and needed technical competencies and provides recommendations for required training.
  1. Proficient in the use of technical systems and processes.
  1. Supports technical training and development of employees.
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. Prioritizes risks based on an understanding of their possible impact to the company.
  1. Understands financial terminology, statements.
  1. Gathers essential customer data to align our products with their expectations.
  1. Aware of regulations that impact our business.
  1. Able to get department employees to accept new business workflows.
  1. Works cooperatively with others to implement business changes.
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. Effectively represents the department in company gatherings.
  1. Impresses upon others the important aspects of [Company].
  1. Maintains positive relationships between the [Company] and the community.
  1. Attends [Company] gatherings and social events.
  1. Expresses loyalty and dedication to [Company] in interactions with others.
  1. Supports [Company]'s marketing efforts.
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.