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 have excellent influencing/negotiating skills.
You attempt to persuade others rather than simply control them.
You are able to express own goals and needs.
You ensure stakeholders are involved in the decision making process.
You persuade others to consider alternative points of view.
Initiative	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I will continue to work on a problem even in the face of obstacles.
You take corrective action to address performance deficiencies/issues.
I take corrective action to rectify issues.
You guide strategic initiatives to advance the department/organization.
I initiate projects that have an impact on the department.
Flexibility	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You foster an environment that prioritizes adaptability, ongoing enhancement, and creative thinking.
You are open to the perspectives/viewpoints of others.
You support a flexible culture that values continuous improvement and innovation.
You adapt workflows according to changing needs.
I am able to change or adjust processes to accommodate changes in equipment or supplies.
Accountability	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You hold employees accountable for their participation in solving department problems and issues.
You accept personal responsibility for the timeliness of work.
You take full responsibility for team's lack of progress.
You define roles, rights, and responsibilities of employees.
You take responsibility for the direction of the team.
Leadership	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You lead team to set goals, solve problems, and accomplish tasks.
You provide resources to enable individuals to develop professionally.
You set a high level of performance expectations and challenges others to do the same.
You demonstrate leadership and courage in critical situations.
You hold others accountable for your actions.
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 help guide employees with prioritizing tasks.
You function well under stress, deadlines, and/or significant workloads.
You align the department's goals with the goals of the organization.
You set appropriate goals for employees.
Achievement	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You successfully complete the orientation training program.
You accept setbacks and challenges as improvement opportunities
You take immediate action of projects that fall behind schedule.
I take calculated risks to achieve significant rewards.
You use established goals and performance measures to keep track of performance.
Interpersonal Skills	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I maintain a high degree of honesty and integrity.
I am a highly respected individual in the company.
I respect other members of the team/department.
You maintain open and regular communication with others.
You are honest about owning up to mistakes made.
Conflict Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I promote openness and urge individuals to explore various options for resolving the conflict.
I seek to reduce the scarcity of limited resources by sourcing materials from new locations.
I ensure that the basic needs of each party are satisfied.
You persuade others to accept personal transformation.
I explore the feasibility of alternative solutions to resolve conflicts.
Recognition	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You let employees know when they have done well
You find opportunities to recognize others.
You say "thank you" to show appreciation for work of others.
You recognize team members who offer a significant contribution to a project.
You recognize the abilities and skills of self and 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.