Persuasion and Influence - 360 Degree Feedback Survey Sample #5

360-Degree Assessment Survey

Dear Employee:

Thank you for providing feedback for the recipient above. As you respond, please draw on your first-hand experience with this individual in the past 12 months. Rate each item using the scale shown. If you don't feel you have enough first-hand information to rate a certain item, please choose the Not Applicable option. Comments can be very helpful; at a minimum where you give a particularly high or low rating, please share your reasons in the Closing Comments section. Your responses will be compiled with feedback from others and presented to the recipient to help guide their ongoing development.

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 by .

Thank you for your participation in the survey.

Management Team

Persuasion and Influence	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Understanding what others need.
Ensures stakeholders are involved in the decision making process.
Persuades others to consider alternative points of view.
Communicates effectively with others.
Attempts to persuade others rather than simply control them.
Time Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Does not procrastinate.
Deals effectively with interruptions.
Sets a good balance between work and family life.
Makes time for developing plans and schedules.
Completes high-priority work within required timelines.
Change Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Is a leading force driving changes.
Effective in dealing with ambiguous and challenging situations.
Develops a strategy for implementing changes.
Develops plans for following through on the changes.
Inspires others to accept changes.
Client Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Prioritizes client issues to tackle the most pressing needs first.
Is consistent in services provided to clients.
Builds trust with the client.
Ensures clients' expectations are met or exceeded.
Actively listens to concerns from clients.
Conflict Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Tries to understand others' point of view before making judgments
Clearly expresses expectations to others.
Helps employees to think through alternative ways to resolve conflict situations.
Assists team members by helping them see the other point of view.
Deals effectively with employee grievances.
Others	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Able to see issues from others' perspectives.
Includes others in the decision making processes.
Is able to see issues from others' perspectives.
...treats others with respect and dignity.
Supports the efforts of other employees in implementing solutions to problems.
Cultural Awareness	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Participates in cultural training sessions/classes.
Open to learning about different cultures.
Understands what customs and etiquette are important for individuals from other cultures.
Avoids referring to stereotypes about others from different cultures.
Acknowledges their own biases in cultural interactions.
Fiscal Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Keeps excellent records for financial transparency.
Monitors spending.
Ensures others follow the correct rules and regulations on fiscal matters.
Provides budgeting and accounting support to the Company.
Effectively manages appropriations, reporting, purchases, expenditures, payrolls, and staff.
Global Perspective	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Communicates effectively on a multi-lingual basis.
Can effectively deliver presentations to international clients.
Respects individual differences.
Builds working relationships with others across cultures.
Develops both the cultural awareness and business skills to grow our business in all countries, and work effectively across borders with employees, customers, and shareowners.

46. Overall, please rate the effectiveness of [Participant Name Here].
    

    5- Very Effective 4- Effective 3- Neither 2- Ineffective 1- Very Ineffective

    
    
47. Strengths
    
    
    
48. Areas for Development
    
    
    
49. Please give any final comments or suggestions for [Participant Name Here]'s assessment.