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 ensure stakeholders are involved in the decision making process.
You persuade others to consider alternative points of view.
You are able to express own goals and needs.
You seek to obtain consensus or compromise.
You have excellent influencing/negotiating skills.
Initiative	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You take the initiative to change the direction or course of events.
You immediately work to complete goals well before your deadline.
You seek and utilize opportunities for continuous learning and self-development.
You take action without being asked.
You go above and beyond the stated goals.
Flexibility	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You adapt to new organizational structures, policies, or procedures.
You work effectively during periods of change.
You are open to the perspectives/viewpoints of others.
You are able to adapt to new situations.
You are willing to try new ideas.
Accountability	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You are someone who is trustworthy.
You define roles, rights, and responsibilities of the team.
You tackle issues head on and finds solutions.
You keep you supervisor informed of recent events.
You act like an owner when they make decisions.
Leadership	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You clearly explain performance expectations and goals to be reached at the beginning of a project, then let others decide how to achieve the goal.
You are able to influence others.
You are a highly effective supervisor.
You effectively lead others.
You take ownership and accountability for results
Establishing Focus/Direction	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You make sure that employees understand how their work relates to organizational goals.
You stay focused even when under pressure and stress.
You make sure that employees understand and identify with the team's mission.
You function well under stress, deadlines, and/or significant workloads.
You maintain self-control when personally criticized.
Achievement	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You complete work to given time frame and to budget
You make a plan for getting things done and drives execution of the strategic plan, actively supporting or leading initiatives to closure.
You systematically work to improve the organization
You follow-up and take action when goals are not met to ensure better results in the future.
You set high standards in your performance
Interpersonal Skills	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You value the opinions of others.
You effectively manage conflicts by dealing with them directly and immediately
You create an atmosphere that supports the open expression of ideas
You apply appropriate communication techniques to the situation.
You are a role model for others
Conflict Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You identify and takes steps to prevent potential confrontations.
You clearly express expectations to others.
You assist team members by helping them see the other point of view.
You try to understand others' point of view before making judgments
You deal effectively with employee grievances.
Recognition	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You are sincerely interested in the suggestions of co-workers
You reinforce and reward employees for accomplishing necessary goals.
You recognize team members who offer a significant contribution to a project.
You compliment other people when they do good work
You make people around them feel appreciated and valued.

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.