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 understand what others need.
You ensure stakeholders are involved in the decision making process.
You persuade others to consider alternative points of view.
You develop a good rapport with others.
You attempt to persuade others rather than simply control them.
Initiative	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I initiate important conversation topics at meetings.
You initiate draft documents for the director.
I build strong interpersonal relationships upon first meeting.
I am proactive and get things done.
I initiate draft reports for consideration.
Flexibility	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You identify new opportunities to achieve goals
You can handle changes without complaining.
You work effectively during periods of change.
You are able to adapt to new situations.
You encourage others to adopt new procedures.
Accountability	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You develop goals and establishes objective measures of success.
You define roles, rights, and responsibilities of employees.
You are someone who is trustworthy.
You implement and facilitate controls and processes that maintain the integrity of the organization.
You accept accountability for your actions and results.
Leadership	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You express clear goals and objectives.
You give direct, constructive, and actionable feedback.
You act decisively in implementing decisions.
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 take ownership and accountability for results
Establishing Focus/Direction	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You align the department's goals with the goals of the organization.
You maintain self-control when personally criticized.
You make sure that employees understand how their work relates to organizational goals.
You stay focused even when under pressure and stress.
You set appropriate goals for employees.
Achievement	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You strive to exceed standards of performance.
You accept setbacks and challenges as improvement opportunities
You set ambitious standards of performance.
You rapidly complete tasks and assignments.
You are driven to complete goals despite obstacles that may arise.
Interpersonal Skills	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You strive for win/win solutions
You are open and approachable
You are able to work with individuals at all levels of the company.
You create an atmosphere that supports the open expression of ideas
You use tact, compassion, and sensitivity in interactions with others.
Conflict Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You try to understand others' point of view before making judgments
You assist team members by helping them see the other point of view.
You help employees to think through alternative ways to resolve conflict situations.
You deal effectively with employee grievances.
You identify and takes steps to prevent potential confrontations.
Recognition	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You readily share credit and gives others opportunity for visibility.
You make people around them feel appreciated and valued.
You offer recognition in a timely manner.
You reinforce and reward employees for accomplishing necessary goals.
You let employees know when they have done well

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.