Passion to Learn - 360 Degree Feedback Survey Sample #8

Questionnaires Measuring Passion to Learn:
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)

You have been selected to provide feedback for the manager listed above. Your feedback is an important part of 's leadership development process. This tool 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 assessment form, please think about your experiences working with this individual during the last six to twelve months. Your responses will be merged with other people's feedback and presented to to guide them in their on-going development. Comments will be shared anonymously, as written, with the manager.

Sample Result Document:
Sample Results
Method of use: As part of the review process, managers will receive feedback from peers and staff. It is recognized that not all participants will be able to assess an individual's performance in all areas. The feedback received will be utilized as input to the manager's performance and on-going development plan.

You may sign out at any time by pressing the Save button at the end of the form and then closing your browser. You may return later to pick up where you left off. When you are done, press the Complete button.

When clicking your selection below, try to best fit the manager's actual behaviors to the scale provided.

If you are not sure, or unable to assess, select "Not Applicable" (N/A) option.

Please complete your response by .

Passion To Learn

Agree Unsure Disagree N/A
  1. Is committed to enhancing their own knowledge and skills.
  1. Creates an environment that supports personal development and exploration.
  1. Recognizes own areas for development and consciously seeks assignments that will provide practice in areas of developmental need.
  1. Stays up-to-date on emerging technologies.
  1. Enhances value to the company through additional training and development.

Supervisory Skills

Agree Unsure Disagree N/A
  1. Provides constructive, ongoing feedback.
  1. Treats all staff equitably.
  1. Maintains good working relationships with employees.
  1. Resolves personnel problems quickly and effectively.
  1. Encourages employees to achieve their full potential.


Agree Unsure Disagree N/A
  1. Defines goals and objectives for subordinates.
  1. Tells subordinates what to do, not how to do it.
  1. Assigns tasks to create learning opportunities for the employees.
  1. Defines the roles, responsibilities, required actions, and deadlines for team members.
  1. Allows subordinates to use their own methods and procedures.


Agree Unsure Disagree N/A
  1. Encourages others to achieve high quality standards.
  1. Encourages employees to produce the best quality products.
  1. Encourages others to produce the highest quality work products.
  1. Always strives to produce the highest quality work products.
  1. Analyze what occurred and re-adjusts accordingly when goals are not met.

Change Management

Agree Unsure Disagree N/A
  1. Effective in dealing with ambiguous and challenging situations.
  1. Addresses organizational and departmental resistance to changes.
  1. Works cooperatively with others to implement changes.
  1. Assists others in understanding changes to the organization.
  1. Supports the Company's efforts to implement changes.

Managing Risk

Agree Unsure Disagree N/A
  1. Creates a risk profile for projects and teams.
  1. Is knowledgeable of standard risk management principles.
  1. Seeks to increase safety in the workplace.
  1. Implements changes to reduce the chances of critical incidents in the future.
  1. Is concerned about process safety management.


Agree Unsure Disagree N/A
  1. Maintains a state of readiness to address new and changing regulations and procedures.
  1. Maintains historical records and documents as needed/required.
  1. Complies with regulatory requirements for the state.
  1. Familiar with EEOC, FLSA, OSHA and ERISA acts/standards.
  1. Keeps up-to-date with legislation affecting employees.

Conflict Management

Agree Unsure Disagree N/A
  1. Tries to understand others' point of view before making judgments
  1. Assists team members by helping them see the other point of view.
  1. Discusses conflict situations with supervisor.
  1. Deals effectively with employee grievances.
  1. Helps employees to think through alternative ways to resolve conflict situations.

Business Acumen

Agree Unsure Disagree N/A
  1. Exhibits behavior that is consistent with the vision, mission, and core values of the organization
  1. Understands complex issues and problems.
  1. Able to align resources to meet the business needs of the company.
  1. Considers impact of actions on other areas of the organization.
  1. Asks the 'right' questions to size up or evaluate situations.

Organizational Fluency

Agree Unsure Disagree N/A
  1. Gets things done through the department.
  1. Understands departmental policies and procedures.
  1. Effective in communicating with others within the organization.
  1. Understands the current organizational culture.
  1. Able to explain departmental policies and procedures to others.

  1. Overall, please rate the effectiveness of [Participant Name Here].

  2. Strengths

  3. Areas for Development

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