Performance - 360 Degree Feedback Survey Sample #8

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)

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 .


Agree Unsure Disagree N/A
  1. Works effectively in the department.
  1. Listens and responds to issues and problems
  1. Effectively organizes resources and plans
  1. Able to organize work.
  1. Effective in performing his/her job.


Agree Unsure Disagree N/A
  1. Conducts timely follow-up; keeps others informed on a need to know basis.
  1. Sets high expectations and goals; encourages others to support the organization.
  1. Makes sure that team members have a clear idea of our group's goals.
  1. Understands & contributes to development of strategic goals.
  1. Makes sure that I have a clear idea of our group's goals.

Results Oriented

Agree Unsure Disagree N/A
  1. Helps others when free-time is available.
  1. Stays focused on meeting the needs of customers.
  1. Does not become distracted by non-issues or interruptions.
  1. Provides clear expectations for employees.
  1. Directs team in prioritizing daily work activities


Agree Unsure Disagree N/A
  1. Takes a lot of pride in their work.
  1. Keeps themselves and others focused on constant improvement.
  1. Demonstrates the analytical skills to do their job.
  1. Demonstrates the functional or technical skills necessary to do their job.
  1. Can be counted on to add value wherever they are involved.

Passion To Learn

Agree Unsure Disagree N/A
  1. Will participate in training classes even if offered outside of normal working hours.
  1. Is open minded and curious about learning new skills.
  1. Demonstrates through personal behavior the commitment to high standards of performance.
  1. Is open to feedback from others.
  1. Creates an environment that supports personal development and exploration.

Continual Learning

Agree Unsure Disagree N/A
  1. Grasps new ideas, concepts, technical, or business knowledge.
  1. Seeks opportunities to grow in skills and knowledge.
  1. Takes charge of their training and skills enhancement.
  1. Is open to new ideas and concepts.
  1. Improves on their skill sets.

Continual Improvement

Agree Unsure Disagree N/A
  1. Looks for ways to expand and learn new job skills.
  1. Open to the suggestions from others.
  1. Analyzes processes to determine areas for improvement.
  1. Looks for ways to expand current job responsibilities.
  1. Searches for new methods, techniques, and processes that increase efficiency and reduce costs.

Persuasion and Influence

Agree Unsure Disagree N/A
  1. Ensures stakeholders are involved in the decision making process.
  1. Seeks to obtain consensus or compromise.
  1. Persuades others to consider alternative points of view.
  1. Communicates effectively with others.
  1. Attempts to persuade others rather than simply control them.

Client Focus

Agree Unsure Disagree N/A
  1. Looks for opportunities that have a positive impact on Clients.
  1. Ensures client commitments and requirements are met or exceeded
  1. Maintains strong relationships with clients.
  1. Is pro-active in dealing with clients and addressing their needs.
  1. Satisfies client needs.

Customer Focus

Agree Unsure Disagree N/A
  1. Develops good rapport and trust with the customer.
  1. Develops strong customer relationships.
  1. Consistently models positive customer service attitudes.
  1. ...friendliness and courtesy
  1. Does not hesitate to address customer concerns or complaints.

Conflict Management

Agree Unsure Disagree N/A
  1. Assists team members by helping them see the other point of view.
  1. Identifies and takes steps to prevent potential confrontations.
  1. Helps employees to think through alternative ways to resolve conflict situations.
  1. Discusses conflict situations with supervisor.
  1. Deals effectively with employee grievances.

Fiscal Management

Agree Unsure Disagree N/A
  1. Provides budgeting and accounting support to the Company.
  1. Effectively manages appropriations, reporting, purchases, expenditures, payrolls, and staff.
  1. Monitors spending.
  1. Monitors expenses and verifies the need for items purchased.
  1. Develops budgets and plans for various programs and initiatives.

  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.