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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)
Survey 13 (4-point scale; numbers; floating anchors)
Survey 14 (4-point scale; N/A)
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.
Edit this Survey
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Performance

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You set a high standard for job performance.
  1. You work effectively in the department.
  1. You work well in this position.
  1. You produce quality
  1. You are effective in performing your job.
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 strong technical/computer skills.
  1. You have strong organizational skills to keep the workspace and department in order
  1. You have a high attention to detail.
  1. You accurately implement contract provisions.
  1. You are able to develop, justify and present a budget.
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 maximize the use of new technology to deliver products and services.
  1. You support technical training and development of employees.
  1. You adopt the implementation of new technology into the workplace.
  1. You apply complex rules and regulations to maintain optimal system performance.
  1. You understand and are committed to implementing new technologies.
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 add value to the department/organization.
  1. You develop solutions to challenging problems.
  1. You are creative.
  1. You inspire creativity in your team.
  1. You are creative and inspirational.
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 step away from a situation to process appropriate response.
  1. You do not allow own emotions to interfere with the performance of others.
  1. You deal with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
  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.
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 have excellent influencing/negotiating skills.
  1. You understand what others need.
  1. You develop a good rapport with others.
  1. You attempt to persuade others rather than simply control them.
  1. You persuade others to consider alternative points of view.
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 are clear about the roles and duties of team members.
  1. You are clear about goals that need to be achieved.
  1. You make sure goals and objectives are clearly and thoroughly explained and understood.
  1. You make sure employees understand why they were given certain assignments.
  1. You clarify problems and their causes to help employees correct them.
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 set performance objectives for subordinates that encourages development opportunities.
  1. You support the successes of other employees.
  1. You assess employees' developmental needs.
  1. You create a work environment that fosters positive feedback to employees.
  1. You encourage employees through recognition of positive changes in behavior.
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 the costs, profits, markets, and added value of issues.
  1. You evaluate risks in terms of their business impact and likelihood of occurrence.
  1. I involve key stakeholders (employees, customers, investors, partners) in the planning process to gain diverse perspectives and buy-in.
  1. I gather important information from customers to make sure our products are relevant and useful.
  1. You periodically assess the current market environment.
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 analyze records and reports to obtain insight into potential issues and trends.
  1. You create strategies that significantly benefit the Company.
  1. You develop a plan and strategy for each functional area within the mission statement.
  1. You create a mission statement describing the purpose for the organization.
  1. I create a vision for the organization based on insights gathered from other companies in the industry.
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.