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

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Persuasion and Influence	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I create an environment where employees can explore new ideas and evolve their approach to problem-solving.
You listen actively to oppose viewpoints and respond with thoughtful counterarguments rather than defensiveness.
You gain participation by others to accomplish goals.
You are aware of how messages may be receive and interpret by individuals.
You use values-based language to inspire alignment and a shared sense of purpose among team members.
Initiative	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I initiate projects that have an impact on the department.
You act with urgency when time is limited.
I immediately work on solving problems.
I proactively identify and remove barriers that inhibit progress without waiting for direction.
You take decisive action to address problems, following up with relevant team members and coaching them on how to improve.
Flexibility	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I encourage a culture of experimentation and innovation.
You adapt workflows according to changing needs.
I ensure that each employee's unique learning style is accommodated, which maximizes the effectiveness of the training.
You are able to change your approach to solving a problem based on new information.
You encourage flexibility in the onboarding process.
Accountability	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You are someone who is trustworthy.
You tackle issues head on and finds solutions.
You welcome the responsibility for meeting the broad range of needs of stakeholders and clients.
You willingly accept the obligation to complete the task.
You are personally invested in the success of the organization.
Leadership	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You encourage mentoring relationships.
You motivate others to reach and exceed organizational goals and objectives.
You suggest methods to reduce stress within work environment.
You take ownership and accountability for results
You only accept exceptional work.
Establishing Focus/Direction	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You motivate and inspire the team by connect their objectives to the organization's.
I plan responses to potential risks or unforeseen challenges to minimize disruption.
I set production schedules for the department.
You lead by example to guide employees in the completion of tasks.
You ensure that the department's plans support the broader vision and strategic goals of the organization.
Achievement	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You establish stretch goals to advance skills and output.
You take calculated risks to achieve higher levels of performance.
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
You push beyond comfort zones to drive breakthroughs and achieve ambitious outcomes.
Interpersonal Skills	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You apply appropriate communication techniques to the situation.
You attend to both the content and the context of what was being said.
I offer praise to colleagues who have successfully completed major projects.
You a good listener who is attentive to others.
You demonstrate good communication with colleagues and customers.
Conflict Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I attempt to determine the root sources of grievances.
You help employees to think through alternative ways to resolve conflict situations.
I promote openness and urge individuals to explore various options for resolving the conflict.
You guide others toward establishing strong relationships.
I facilitate the resolution of grievances by fostering mutual understanding and appreciation of each party's needs.
Recognition	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You understand the power of recognition as a motivator of job performance.
You make sure there are adequate budget resources to support monetary rewards.
I encourage peers and colleagues to recognize each other when their work fit in with the company mission and core values.
I use both formal and informal rewards to recognize employees.
You give recognition that reflect the values of the department/organization.

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.