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.

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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
Develops a good rapport with others.
Attempts to persuade others rather than simply control them.
Able to express own goals and needs.
Communicates effectively with others.
Seeks to obtain consensus or compromise.
Time Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Keeps and maintains a To-Do list.
Focuses on tasks that have high priority.
Makes time for developing plans and schedules.
Prioritizes new tasks according to their relative importance.
Sets a good balance between work and family life.
Change Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Works cooperatively with others to implement changes.
Supports new initiatives for organizational changes to improve effectiveness.
Adopts changes to set and example for others to follow.
Effective in dealing with ambiguous and challenging situations.
Assists others in understanding changes to the organization.
Client Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Ensures client commitments and requirements are met or exceeded
Is pro-active in dealing with clients and addressing their needs.
Forms strong client relationships
Maintains strong relationships with clients.
Satisfies client needs.
Conflict Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Discusses conflict situations with supervisor.
Clearly expresses expectations to others.
Assists team members by helping them see the other point of view.
Identifies and takes steps to prevent potential confrontations.
Tries to understand others' point of view before making judgments
Others	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Supports the efforts of other employees in implementing solutions to problems.
Works effectively with people from other departments.
Includes others in the decision making processes.
Able to see issues from others' perspectives.
Constructively receives criticism and suggestions from others.
Cultural Awareness	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Recognizes and values individual and cultural differences.
Values the opinions of diverse groups and individual.
Respects others regardless of age, race, gender, nationality, or disability.
Encourages a work environment where individual differences are valued.
Fosters a diverse workforce free from discrimination and harassment.
Fiscal Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Monitors expenses and verifies the need for items purchased.
Provides budgeting and accounting support to the Company.
Keeps excellent records for financial transparency.
Monitors spending.
Effective in using Company's resources.
Global Perspective	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Works well with others from different cultural backgrounds.
Comfortable using teleconferencing equipment to facilitate meetings with others abroad.
Builds working relationships with others across cultures.
Is able to work with individuals having different backgrounds and cultures.
Able to work with others from different cultures and countries.

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.