Persuasion and Influence - 360 Degree Feedback Survey Sample #6

360-Degree Assessment Survey

Dear Employee:

You have been selected to participate in a 360-assessment. As part of this process you will need to complete the self-assessment questionnaire below.

In responding to the questions below, think about your experiences over the last 12 months. The effectiveness of this development tool is dependent on your honest, forthright and constructive responses so please bear this in mind as you answer each question. Your responses will be aggregated with the responses received from others. A report will be shared with you at the conclusion of this project.

We encourage everyone to complete the survey. Please be honest, constructive and thoughtful in your input. The survey is designed to help us understand more about your thoughts and needs to make this a great company.

The results of this survey will be used to help drive our future success. We will report back to you about what you have said and what we plan to do about it. If you have any questions about the process please contact [Contact Person].

Please ensure that your submission is made between . The survey will only be available during these dates.

Thank you for your participation in the survey. We look forward to seeing the analysis of your responses and we are hoping for 100% participation.

Management Team

Persuasion and Influence	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You seek to obtain consensus or compromise.
You are able to express own goals and needs.
You communicate effectively with others.
You understand what others need.
You develop a good rapport with others.
Initiative	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You go above and beyond the stated goals.
You take on extra projects after required work is completed.
I act independently to solve pressing needs.
I gladly seek additional responsibilities.
You take corrective action to address performance deficiencies/issues.
Flexibility	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You act decisively in frequently changing and uncertain environment.
You are willing to try new ideas.
You implement changes as a result of having listened to employees
You are open to alternative ways to accomplish goals
You adapt to new organizational structures, policies, or procedures.
Accountability	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I set clear performance measures.
You show up for work on time.
You take responsibility for seeing the project through to completion.
You accept accountability for your work.
You accept responsibility for leading efforts to solve critical problems.
Leadership	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You are able to organize the work of others.
You are a highly effective supervisor.
You are able to align manpower, design work, an allocate tasks to achieve goals.
You sit down regularly with employees to review your job performance.
You are a highly effective supervisor.
Establishing Focus/Direction	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You maintain focus when handling several problems or tasks simultaneously.
You maintain self-control when personally criticized.
You stay focused even when under pressure and stress.
You function well under stress, deadlines, and/or significant workloads.
You help guide employees with prioritizing tasks.
Achievement	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I can complete required training and certification.
You accept setbacks and challenges as improvement opportunities
You demonstrate a sense of urgency to quickly and accurately solve problems and issues.
I am highly motivated to achieve or exceed performance standards.
You complete work to given time frame and to budget
Interpersonal Skills	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You anticipate the concerns of other employees.
You build a strong rapport with co-workers.
I am willing to overlook personal differences and focus on completing the task at hand.
I demonstrate a high degree of ethics and integrity in the workplace.
I am honest about making mistakes and willing to fix them.
Conflict Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You help employees to think through alternative ways to resolve conflict situations.
You clearly express expectations to others.
You deal effectively with employee grievances.
You try to understand others' point of view before making judgments
You identify and takes steps to prevent potential confrontations.
Recognition	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You recognize team members who offer a significant contribution to a project.
You recognize individuals for a specific outstanding achievement.
You are sincerely interested in the suggestions of co-workers
You compliment other people when they do good work
You reinforce and reward employees for accomplishing necessary goals.

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

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

    
    
52. Describe the greatest strengths of this person with regard to his/her overall effectiveness in performing his/her current responsibilities.
    
    
    
53. Describe the most important things this person could improve upon in order to increase his/her overall effectiveness in performing his/her current responsibilities.
    
    
    
54. Additional comments, if any for [Participant Name Here]'s assessment.