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
Ensures stakeholders are involved in the decision making process.
Communicates effectively with others.
Attempts to persuade others rather than simply control them.
Has excellent influencing/negotiating skills.
Able to express own goals and needs.
Time Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Successfully completes critical tasks within deadlines.
Uses scripts or software tools to automate computer centered processes.
Focuses time on the tasks that yield the highest value.
Focuses time on the important tasks that add significant value.
Organizes work responsibilities for maximum efficiency.
Change Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Effective in implementing new organizational vision and values.
Inspires others to want to change.
Is an inspiration for others to accept the recent changes.
Adopts changes to set and example for others to follow.
Develops plans for following through on the changes.
Client Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Tailors innovative products for each client.
Forms strong client relationships
Tailors solutions to meet the specific needs of each client.
Makes sure team members understand the issues faced by the client.
Actively listens to concerns from clients.
Conflict Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Encourages both sides to make compromises to resolve the conflict.
Determines who has the autonomy (authority) to make the decisions necessary to end the conflict.
Combines different ideas and viewpoints.
Works with others as needed to facilitate resolution of conflicts.
Initates collaborative processes to reduce conflict.
Others	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Is able to see issues from others' perspectives.
Respects the opinions of other employees.
Includes others in the decision making processes.
Supports the efforts of other employees in implementing solutions to problems.
Forms working relationships with employees from other departments.
Cultural Awareness	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Shows respect in daily interactions
Maintains an inclusive work environment that maximizes the talents of others in achieving goals.
Understands how implicit biases can affect decisions, communication and productivity.
Is aware of the similarities and differences among and between cultural groups.
Effective in working with individuals with a variety of cultural backgrounds.
Fiscal Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Ensures others follow the correct rules and regulations on fiscal matters.
Monitors spending.
Develops budgets and plans for various programs and initiatives.
Develops of the department's annual budget.
Effectively manages appropriations, reporting, purchases, expenditures, payrolls, and staff.
Global Perspective	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Engages in problem solving with individuals outside of the country.
Is aware of the culture, behaviors, identities and beliefs of others.
Respects individual differences.
Can effectively deliver presentations to international clients.
Able to listen and understand others and discuss issues in a respectful way.

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.