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 shown significant improvement in job performance.
  1. You set a high standard for job performance.
  1. You produce quality
  1. You are able to organize work.
  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 take responsibility for decisions.
  1. You have a high attention to detail.
  1. You complete reports on-time.
  1. You have strong technical/computer skills.
  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 support technical training and development of employees.
  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 are proficient in the use of technical systems and processes.
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 create a lot of new ideas.
  1. You are creative and inspirational.
  1. You conceive, implement and evaluate ideas.
  1. You add value to the department/organization.
  1. You are creative.
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 deal with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
  1. You set an example for associates during stressful periods by maintaining a positive, can-do attitude.
  1. You use patience and self-control in working with customers and associates.
  1. You consciously control own negative emotions in order to keep team morale up.
  1. You step away from a situation to process appropriate response.
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 ensure stakeholders are involved in the decision making process.
  1. You attempt to persuade others rather than simply control them.
  1. You are able to express own goals and needs.
  1. You persuade others to consider alternative points of view.
  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 are clear about goals that need to be achieved.
  1. You adjust communication methods to the needs of the audience.
  1. You are clear about the roles and duties of team members.
  1. You avoid creating ambiguity or mixed messages.
  1. You clearly define work objectives for employees.
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 assign tasks and responsibilities to develop skills of others.
  1. You develop employees by offering and encouraging them to take on new or additional responsibilities.
  1. You are open to receiving feedback.
  1. You create a work environment that fosters positive feedback to employees.
  1. You set performance objectives for subordinates that encourages development opportunities.
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. I am aware of regulations that impact our business.
  1. I incorporate innovative approaches and being adaptable to change.
  1. I understand cash flow procedures and statements.
  1. You understand the costs, profits, markets, and added value of issues.
  1. You understand the dynamics of our industry.
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 maintain knowledge of current trends in the industry.
  1. You create strategies that significantly benefit the Company.
  1. You analyze records and reports to obtain insight into potential issues and trends.
  1. You work with others to develop insights into the resources and actions required to produce desired results.
  1. You identify potential problems before they become critical incidents.
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.