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 attempt to persuade others rather than simply control them.
You seek to obtain consensus or compromise.
You understand what others need.
You communicate effectively with others.
You are able to express own goals and needs.
Initiative	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I build strong interpersonal relationships upon first meeting.
I inspire others to perform above expectations.
You independently seek out new learning opportunities to improve your skills.
You act quickly to address any issues or problems.
I take charge when there is a crisis.
Flexibility	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You adapt to new organizational structures, policies, or procedures.
I possess a high degree of flexibility to meet the challenges posed by unforeseen circumstances.
You incorporate new skills fluently.
You show a readiness to adapt and optimize.
You navigate ambiguity with ease, maintaining focus and productivity amidst uncertainty.
Accountability	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You accept accountability for your actions and results.
You take responsibility for your actions and admit mistakes openly.
I recognize when a mistake is made and work to correct the issue.
You work hard to ensure the success of the department.
You take responsibility for results.
Leadership	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You motivate others to reach and exceed organizational goals and objectives.
You hold others accountable for your actions.
You are able to align manpower, design work, an allocate tasks to achieve goals.
You demonstrate leadership and courage in critical situations.
You express clear goals and objectives.
Establishing Focus/Direction	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You maintain self-control when personally criticized.
You are excellent at managing time.
You stay focused even when under pressure and stress.
You make sure that employees understand how their work relates to organizational goals.
You function well under stress, deadlines, and/or significant workloads.
Achievement	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I take calculated risks to achieve difficult goals.
You inspire others to work with a sense of urgency.
You help others to improve or meet standards of performance.
You strive to meet goals and objectives.
You make a plan for getting things done and drives execution of the strategic plan, actively supporting or leading initiatives to closure.
Interpersonal Skills	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You value the opinions of others.
I consider the other individual's point of view.
I respect other members of the team/department.
I offer constructive criticism to have a positive impact on performance.
You apply appropriate communication techniques to the situation.
Conflict Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I help to maintain dignity of all persons involved.
I try to ensure that all basic needs are satisfied.
I remove misperceptions that may be contributing to the conflict.
I strive to ensure that all basic needs are met, resulting in mutual benefits for both parties.
I encourage individuals to modify their underlying work behaviors that may have contributed to the conflict.
Recognition	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You offer recognition in a timely manner.
You recognize individuals for a specific outstanding achievement.
You compliment other people when they do good work
You let employees know when they have done well
You find opportunities to recognize others.

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.