Performance - 360 Degree Feedback Survey Sample #1





360-Degree Feedback Survey

Questionnaires Measuring Performance:
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:

[Company] is conducting a 360-Degree Feedback Assessment developed by HR-Survey for selected managers.

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. 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 aggregated with the responses received from others and discussed with the employee to foster growth and on-going development.

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.

Competencies Included:
Performance, Achievement, Empowering Others, Teamwork, Adaptability, Action, Continual Learning, Leadership, Company, Vision
Sample Result Document:
Sample Results
Your feedback is valuable in helping the individual to understand how they are perceived and experienced by others and the impact their behavior has on people in the organization with whom they interact. Feedback received also acknowledges strengths and identifies areas for development.

Use the form below to provide your feedback. Each field and comment box requires a response before you can SUBMIT your final feedback.

Please ensure that your submission is made between . The survey will only be available during these dates.

Thank you for your participation in the survey. We look forward to seeing the analysis of your responses and we are hoping for 100% participation.

Management Team


Performance

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. ...Overall Performance
  1. Sets a high standard for job performance.
  1. Works effectively in the department.
  1. Works well in this position.
  1. Effectively organizes resources and plans
If [Participant Name] were to make improvements in Performance, what are your suggestions for how he/she can improve this?

Achievement

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Reduced department expenses by 25 percent.
  1. Takes immediate action of projects that fall behind schedule.
  1. Completes work promptly and efficiently.
  1. Inspires others to work with a sense of urgency.
  1. Increased revenue for the company.
If [Participant Name] were to make improvements in Achievement, what are your suggestions for how he/she can improve this?

Empowering Others

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Allows employees to make their own decisions.
  1. Gives employees input into the decision making process.
  1. Enables employees to take on more challenging roles.
  1. Recognizes the expertise that employees have in certain areas and allows them the freedom to operate as they see fit.
  1. Set clear goals for assignments.
If [Participant Name] were to make improvements in Empowering Others, what are your suggestions for how he/she can improve this?

Teamwork

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Works cooperatively with others to solve problems.
  1. Helps the team decide what long term goals need to be met.
  1. Supports open communication between team members.
  1. Is committed to the success of the team.
  1. Encourages teamwork and collaboration.
If [Participant Name] were to make improvements in Teamwork, what are your suggestions for how he/she can improve this?

Adaptability

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Performs a wide range of tasks, responds to changes in direction and priorities and accepts new challenges, responsibilities, and assignments.
  1. Responds quickly to new information.
  1. Responsive to the needs of others.
  1. Adjusts plans as needed based on changing conditions.
  1. Accommodates changes as needed.
If [Participant Name] were to make improvements in Adaptability, what are your suggestions for how he/she can improve this?

Action

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Fixes problems when they occur.
  1. Takes action to respond to dissatisfied customer.
  1. Gladly accepts new challenges and works on them with urgency.
  1. Is ambitious when working on the project.
  1. Motivates & supports others to gain skills
If [Participant Name] were to make improvements in Action, what are your suggestions for how he/she can improve this?

Continual Learning

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Shares best practices with others and learns from others.
  1. Builds on their strengths while addressing their weaknesses.
  1. Pursues professional development opportunities when they arise.
  1. Participates in regular training offered.
  1. Takes charge of their training and skills enhancement.
If [Participant Name] were to make improvements in Continual Learning, what are your suggestions for how he/she can improve this?

Leadership

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Effectively leads others.
  1. Highly effective supervisor.
  1. Demonstrates leadership and courage in critical situations.
  1. Is a highly effective supervisor.
  1. Gives inspiring presentations or discussions.
If [Participant Name] were to make improvements in Leadership, what are your suggestions for how he/she can improve this?

Company

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Expresses loyalty and dedication to [Company] in interactions with others.
  1. Impresses upon others the important aspects of [Company].
  1. Understands the use of [Company] products and services.
  1. Follows existing procedures and processes.
  1. Attends [Company] gatherings and social events.
If [Participant Name] were to make improvements in Company, what are your suggestions for how he/she can improve this?

Vision

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Leads employees in new directions.
  1. Creates a common vision for others.
  1. Works to support the strategy of [Company]
  1. Develops action plans to align his/her work with the goals of the organization
  1. Understands the vision of the Company and promotes it ahead of any self-interests.
If [Participant Name] were to make improvements in Vision, what are your suggestions for how he/she can improve this?

  1. What are [Participant Name Here]'s greatest strengths demonstrated this year?


  2. What are [Participant Name Here]'s areas for development?


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