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)

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.

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 well in this position.
  1. Effective in performing his/her job.
  1. ...Produce Quality
  1. Has great overall performance
  1. Sets a high standard for job performance.


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

Results Oriented

Agree Unsure Disagree N/A
  1. Demonstrates the personal confidence to "stay the course," even when faced with difficulty
  1. Encourages a high-energy, fun work environment and coaches others on how to do the same
  1. Directs team in prioritizing daily work activities
  1. Provides clear expectations for employees.
  1. Stays focused on meeting the needs of customers.


Agree Unsure Disagree N/A
  1. Takes a lot of pride in their work.
  1. Can be counted on to add value wherever they are involved.
  1. Produces high quality work.
  1. Is planful and organized.
  1. Demonstrates the analytical skills to do their job.

Passion To Learn

Agree Unsure Disagree N/A
  1. Takes initiative for own learning and development.
  1. Is motivated by the desire to be "the best".
  1. Demonstrates through personal behavior the commitment to high standards of performance.
  1. Critiques own performance and learns from experience as a source of continuous improvement.
  1. Persists until goals are achieved and commitments are met.

Continual Learning

Agree Unsure Disagree N/A
  1. Grasps new ideas, concepts, technical, or business knowledge.
  1. Shares best practices with others and learns from others.
  1. Builds on their strengths while addressing their weaknesses.
  1. Sets relevant learning objectives and goals.
  1. Pursues self-improvement through continual learning.

Continual Improvement

Agree Unsure Disagree N/A
  1. Looks for ways to expand and learn new job skills.
  1. Looks for ways to expand current job responsibilities.
  1. Looks for ways to improve work processes and procedures.
  1. Promotes training and development opportunities to enhance job performance.
  1. Open to the suggestions from others.

Persuasion and Influence

Agree Unsure Disagree N/A
  1. Persuades others to consider alternative points of view.
  1. Communicates effectively with others.
  1. Develops a good rapport with others.
  1. Attempts to persuade others rather than simply control them.
  1. Has excellent influencing/negotiating skills.

Client Focus

Agree Unsure Disagree N/A
  1. Obtains feedback to ensure client needs are being met.
  1. Forms strong client relationships
  1. Ensures client commitments and requirements are met or exceeded
  1. Satisfies client needs.
  1. Is pro-active in dealing with clients and addressing their needs.

Customer Focus

Agree Unsure Disagree N/A
  1. Does not hesitate to address customer concerns or complaints.
  1. Develops strong customer relationships.
  1. Develops good rapport and trust with the customer.
  1. Considers customers point of view when making decisions.
  1. Ensures all customer commitments and requirements are met or exceeded.

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. Clearly expresses expectations to others.
  1. Discusses conflict situations with supervisor.
  1. Tries to understand others' point of view before making judgments

Fiscal Management

Agree Unsure Disagree N/A
  1. Ensures others follow the correct rules and regulations on fiscal matters.
  1. Effectively manages appropriations, reporting, purchases, expenditures, payrolls, and staff.
  1. Monitors spending.
  1. Keeps excellent records for financial transparency.
  1. Monitors expenses and verifies the need for items purchased.

  1. Overall, please rate the effectiveness of .

  2. Strengths

  3. Areas for Development

  4. Please give any final comments or suggestions for 's assessment.