Others- 360 Degree Feedback Survey Sample #11





360 Feedback Survey

Assessments 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

We appreciate you taking the time to provide valuable feedback for the individual mentioned above. As you respond, please draw on your first-hand experience with this individual in the past 12 months. Your insights are crucial in offering a comprehensive evaluation. Please rate each item using the scale provided. If you find that you do not have sufficient first-hand knowledge to rate a particular item, select the Not Applicable option.

In addition to the ratings, we encourage you to include comments where possible. These comments are particularly useful when you give a very high or very low rating, as they provide context and clarity regarding your assessment. Explaining your reasons in the comment section helps ensure that your feedback is constructive and actionable.

Your responses, combined with feedback from other contributors, will be compiled and presented to the individual. This collective feedback aims to support their continuous growth and development by highlighting strengths and identifying areas for improvement. Your thoughtful participation is essential in helping them achieve their full potential.

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
To what extent does [Participant Name] exhibit the following ...

SELECT the rating that best reflects the employee's performance in the areas listed.


Others

What does Others mean?
It means that ...
  • You treat others with respect and dignity.
  • You are able to see issues from others' perspectives.
  • You work effectively with people from other departments.
  • You include others in the decision making processes.
  • You treat others with respect and dignity.

To what extent does this person exhibit Others?
Select from one of the ratings below.

Commitment To Result

What does Commitment To Result mean?
It means that ...
  • You are able to focus on a task even when working alone.
  • You are willing to do whatever it takes-not afraid to have to put in extra effort.
  • You are committed to the team.
  • You convey strong sense of own pride in Company to associates by creating a shared vision around sales and customer service.
  • You create a sense of urgency among the store team members to complete activities, which drive sales.

To what extent does this person exhibit Commitment To Result?
Select from one of the ratings below.

Self Management

What does Self Management mean?
It means that ...
  • You deal with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
  • You consciously control own negative emotions in order to keep team morale up.
  • You are aware of personal impact on others and adjusts behavior to create a positive leadership presence.
  • You use patience and self-control in working with customers and associates.
  • You analyze interpersonal problems instead of reacting to them.

To what extent does this person exhibit Self Management?
Select from one of the ratings below.

Fiscal Management

What does Fiscal Management mean?
It means that ...
  • You effectively manage appropriations, reporting, purchases, expenditures, payrolls, and staff.
  • You monitor spending.
  • You develop of the department's annual budget.
  • You develop budgets and plans for various programs and initiatives.
  • You ensure others follow the correct rules and regulations on fiscal matters.

To what extent does this person exhibit Fiscal Management?
Select from one of the ratings below.

Persuasion and Influence

What does Persuasion and Influence mean?
It means that ...
  • You develop a good rapport with others.
  • You attempt to persuade others rather than simply control them.
  • You seek to obtain consensus or compromise.
  • You ensure stakeholders are involved in the decision making process.
  • You are able to express own goals and needs.

To what extent does this person exhibit Persuasion and Influence?
Select from one of the ratings below.
Strengths


Areas for Development


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