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
You are able to express own goals and needs.
You have excellent influencing/negotiating skills.
You understand what others need.
You communicate effectively with others.
You seek to obtain consensus or compromise.
Initiative	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I capitalize on opportunities as they become available.
You initiate new projects for the department.
I inspire others to perform above expectations.
You help the department take the initiative to create new solutions.
I create solutions to problems as soon as an incident occurs.
Flexibility	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You adapt workflows according to changing needs.
I embrace change, values feedback, and is willing to experiment with different methods to find the most effective solutions.
I respond to changing governmental regulations.
I support a culture that values flexibility, continuous improvement and innovation.
I expand productive capacity as demand for services increases.
Accountability	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I accept the consequences for my actions.
I provide clear reasons for underperformance.
You take ownership of mistakes and learn from them.
You consult with the supervisor before engaging in new procedures that have some risk.
You encourage employees to take on greater responsibilities.
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 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 sit down regularly with employees to review your job performance.
You are able to influence others.
You take ownership and accountability for results
Establishing Focus/Direction	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You help guide employees with prioritizing tasks.
You make sure that employees understand how their work relates to organizational goals.
You set appropriate goals for employees.
You function well under stress, deadlines, and/or significant workloads.
You align the department's goals with the goals of the organization.
Achievement	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You are determined to complete tasks regardless of obstacles that may occur.
You follow-up and take action when goals are not met to ensure better results in the future.
You are driven to complete assignments on time.
You establish Specific Measurable Achievable Realistic and Timed (SMART) goals.
You work at a quick pace to complete a high volume of work.
Interpersonal Skills	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I keep commitments made with coworkers.
You value the opinions of others.
You adapt management style to meet the needs of the individual or situation.
You see value in the diversity of individuals on the team.
I take time to recognize the efforts of others.
Conflict Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I investigate opportunities to achieve mutually beneficial solutions to conflicts.
I see conflicts as chances to develop innovative and effective solutions.
I avoid being judgmental and micromanaging of employees.
I encourage team members to express their ideas and concerns openly.
I view conflicts as opportunities to create constructive and novel solutions to problems.
Recognition	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You find opportunities to recognize others.
You offer recognition in a timely manner.
You make people around them feel appreciated and valued.
You recognize the abilities and skills of self and others
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.