Performance - 360 Degree Feedback Survey Sample #2





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)
Self-Assessment Instructions

You have been asked to complete a self-assessment questionnaire form (shown below). You will also receive feedback from others such as your peers, direct reports and manager. 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 as an employee over the last twelve months and the goals you 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 become part of the assessment process to foster your growth and on-going development.

Competencies Included:
Performance, Administrative Skill, Technology Use/Management, Creativity, Self Management, Persuasion and Influence, Clarity, Developing Others, Business Acumen, Strategic Insight
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.


Performance

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You effectively organize resources and plans
  1. You shown significant improvement in job performance.
  1. You produce quality
  1. You have great overall performance
  1. You set a high standard for job performance.
What are your suggestions for how you can make improvements
in Performance?

Administrative Skill

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You have a high attention to detail.
  1. You are able to develop, justify and present a budget.
  1. You accurately implement contract provisions.
  1. You implement and use performance measures.
  1. You are enthusiastic about taking on challenging projects.
What are your suggestions for how you can make improvements
in Administrative Skill?

Technology Use/Management

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You support employee training and development initiatives regarding implementation of technology.
  1. You use technology in decision making and problem solving.
  1. You identify gaps between actual and needed technical competencies and provide recommendations for required training.
  1. You understand and are committed to implementing new technologies.
  1. You apply complex rules and regulations to maintain optimal system performance.
What are your suggestions for how you can make improvements
in Technology Use/Management?

Creativity

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You inspire creativity in your team.
  1. You are creative.
  1. You are creative and inspirational.
  1. You develop solutions to challenging problems.
  1. You conceive, implement and evaluate ideas.
What are your suggestions for how you can make improvements
in Creativity?

Self Management

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You analyze interpersonal problems instead of reacting to them.
  1. You are aware of personal impact on others and adjusts behavior to create a positive leadership presence.
  1. You step away from a situation to process appropriate response.
  1. You deal with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
  1. You use patience and self-control in working with customers and associates.
What are your suggestions for how you can make improvements
in Self Management?

Persuasion and Influence

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You develop a good rapport with others.
  1. You ensure stakeholders are involved in the decision making process.
  1. You attempt to persuade others rather than simply control them.
  1. You have excellent influencing/negotiating skills.
  1. You communicate effectively with others.
What are your suggestions for how you can make improvements
in Persuasion and Influence?

Clarity

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You avoid stating unclear or conflicting goals.
  1. You communicate with clarity and efficiency.
  1. You attend to the important details of a job or task.
  1. You clearly explains responsibilities to individuals.
  1. You adjust communication methods to the needs of the audience.
What are your suggestions for how you can make improvements
in Clarity?

Developing Others

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You develop employees by offering and encouraging them to take on new or additional responsibilities.
  1. You assess employees' developmental needs.
  1. You encourage employees through recognition of positive changes in behavior.
  1. You recognize and celebrates accomplishments of others.
  1. You provide constructive feedback to others.
What are your suggestions for how you can make improvements
in Developing Others?

Business Acumen

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You understand complex issues and problems.
  1. You understand and apply business and financial principles.
  1. You can effectively interpret and analyze data.
  1. You understand financial terminology, statements.
  1. I know how to use financial information to make an impact on the organization.
What are your suggestions for how you can make improvements
in Business Acumen?

Strategic Insight

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You understand how to strategically grow the business and increase customers.
  1. You adjust strategic plans based on insights gathered from different points of view.
  1. You create a mission statement describing the purpose for the organization.
  1. You understand the Company's strengths and weaknesses and uses this information to create optimal solutions to problems.
  1. You ommunicate with employees to find out their needs.
What are your suggestions for how you can make improvements
in Strategic Insight?


  1. Strengths


  2. Areas for Development


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