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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.

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.
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Others

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Works effectively with people from other departments.
  1. Treats others with respect and dignity.
  1. Forms working relationships with employees from other departments.
  1. Is able to see issues from others' perspectives.
  1. Helpful
  1. Works across boundaries within the organization.
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. Able to adapt to changes in technology and processes.
  1. Will stop what they are doing to help colleagues in need.
  1. Handles changes easily.
  1. Willing to change ideas or perceptions based on new information or contrary evidence which is presented.
  1. Handles unexpected events without a loss of productivity.
  1. Adjusts tactics when things are not working as expected.
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. Consciously controls own negative emotions in order to keep team morale up.
  1. Steps away from a situation to process appropriate response.
  1. Analyzes interpersonal problems instead of reacting to them.
  1. Deals with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
  1. Uses patience and self-control in working with customers and associates.
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 focus when handling several problems or tasks simultaneously.
  1. Aligns the department's goals with the goals of the organization.
  1. Sets appropriate goals for employees.
  1. Stays focused even when under pressure and stress.
  1. Makes sure that employees understand how their work relates to organizational goals.
  1. Maintains self-control when personally criticized.
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. Maximizes the efficient use of scarce resources such as time and money.
  1. Identifies opportunities for progress and innovation.
  1. Understands and capitalizes on relationships between conflicting goals.
  1. Uses algorithms and quantitative models to determine the costs/benefits of different programs based on mathematical and statistical analysis.
  1. Able to dissect a problem into its core elements.
  1. Creates presentations that are straight forward to understand.
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. Develops creative solutions.
  1. Effectively uses a variety of problem-solving/analytical approaches to address challenges within the Area.
  1. Takes preventative action to address issues before they become difficult to manage.
  1. Conducts a thorough and careful analysis of the underlying causes of problems.
  1. Understands the root causes of problems.
  1. Implements solutions and evaluates results.
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. Proficient in the use of technical systems and processes.
  1. Uses technology in decision making and problem solving.
  1. Understands and is committed to implementing new technologies.
  1. Supports employee training and development initiatives regarding implementation of technology.
  1. Supports technical training and development of employees.
  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. Is up-to-date with regulatory guidelines and policies.
  1. Ensures employees have easy access to relevant information.
  1. Understands the dynamics of our industry.
  1. Understands cash flow procedures and statements.
  1. Understands complex issues and problems.
  1. Understands business fundamentals and practices.
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. Understands the "basics" as to how [Company] functions/operates.
  1. Follows existing procedures and processes.
  1. Understands the use of [Company] products and services.
  1. Supports [Company]'s strategic objectives.
  1. Maintains positive relationships between the [Company] and the community.
  1. Effectively represents the department in company gatherings.
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.