Persuasion and Influence - 360 Degree Feedback Survey Sample #8

Questionnaires Measuring Persuasion and Influence:
Survey 1 (4-point scale; Competency Comments)
Survey 2 (4-point scale; Competency Comments)
Survey 3 (5-point scale; Competency Comments)
Survey 4 (5-point scale; radio buttons)
Survey 5 (4-point scale; words)
Survey 6 (4-point scale; words)
Survey 7 (5-point scale; competency comments; N/A)
Survey 8 (3-point scale; Agree/Disagree words; N/A)
Survey 9 (3-point scale; Strength/Development; N/A)

You have been selected to provide feedback for the manager listed above. Your feedback is an important part of 's leadership development process. This tool is intended to gather broad feedback in the core competencies and role responsibilities that are important for the on-going success of our organization.

In responding to the assessment form, please think about your experiences working with this individual during the last six to twelve months. Your responses will be merged with other people's feedback and presented to to guide them in their on-going development. Comments will be shared anonymously, as written, with the manager.

Method of use: As part of the review process, managers will receive feedback from peers and staff. It is recognized that not all participants will be able to assess an individual's performance in all areas. The feedback received will be utilized as input to the manager's performance and on-going development plan.

You may sign out at any time by pressing the Save button at the end of the form and then closing your browser. You may return later to pick up where you left off. When you are done, press the Complete button.

When clicking your selection below, try to best fit the manager's actual behaviors to the scale provided.

If you are not sure, or unable to assess, select "Not Applicable" (N/A) option.

Please complete your response by .

Persuasion and Influence

Agree Unsure Disagree N/A
  1. Develops a good rapport with others.
  1. Seeks to obtain consensus or compromise.
  1. Able to express own goals and needs.
  1. Understanding what others need.
  1. Attempts to persuade others rather than simply control them.

Problem Solving

Agree Unsure Disagree N/A
  1. Ability to solve problems at root cause rather than at symptom level.
  1. Solves problems using logic and insight.
  1. Ability to develop innovative solutions to problems.
  1. Works cooperatively with others to solve problems.
  1. Identifies and assesses all potential responses to a problem.


Agree Unsure Disagree N/A
  1. Works to eliminate unnecessary work or barriers that get in others' way.
  1. Treats all people fairly and with respect.
  1. Visibly supports and encourages diversity in style and background.
  1. Contributes to a positive and fun work environment.
  1. Shows by their actions that they trust in the positive intentions of others.

Cultural Awareness

Agree Unsure Disagree N/A
  1. Respects others regardless of age, race, gender, nationality, or disability.
  1. Values the opinions of diverse groups and individual.
  1. Recognizes and values individual and cultural differences.
  1. Seeks out different viewpoints and benefits from different perspectives.
  1. Maintains an inclusive work environment that maximizes the talents of others in achieving goals.


Agree Unsure Disagree N/A
  1. Takes the initiative to change the direction or course of events.
  1. Immediately works to complete goals well before their deadline.
  1. Coach others to foster an environment which can adapt quickly and willingly to rapid change.
  1. Seeks and utilizes opportunities for continuous learning and self-development.
  1. Prepares for unexpected contingencies.

Results Oriented

Agree Unsure Disagree N/A
  1. Explains the "whys" behind organizational objectives
  1. Inspires and motivates co-workers to be productive and energetic at work
  1. Demonstrates the personal confidence to "stay the course," even when faced with difficulty
  1. Stays focused on meeting the needs of customers.
  1. Directs team in prioritizing daily work activities


Agree Unsure Disagree N/A
  1. Checks details thoroughly.
  1. Avoids stating unclear or conflicting goals.
  1. Makes sure goals and objectives are clearly and thoroughly explained and understood.
  1. Attends to the important details of a job or task.
  1. Communicates ideas and facts clearly and effectively in writing.

Managing Risk

Agree Unsure Disagree N/A
  1. Seeks to maintain the long-term viability of the Company.
  1. Works within constraints of the organization.
  1. Able to adapt quickly to changing situations.
  1. Rewards innovative experiments to try new ideas.
  1. Knows how to obtain desired results with minimal losses.

Co-worker Development

Agree Unsure Disagree N/A
  1. Adapts coaching and mentoring approach to meet the style or needs of individuals
  1. Gives others development opportunities through project assignments and increased job responsibilities
  1. Provides ongoing feedback to co-workers on their development progress
  1. Sets and clearly communicates expectations, performance goals, and measurements to others


Agree Unsure Disagree N/A
  1. Able to say "no" when it is essential to maintaining quality and high standards.
  1. Resolves difficult negotiations whether it is a contract, sub contract, legal or any other difficult negotiation fairly and reasonably.
  1. Leverages relationships with others to achieve goals.
  1. Influences others through rational argument and persuasion.
  1. Is able to decline bad ideas to avoid making poor decisions.

  1. Overall, please rate the effectiveness of .

  2. Strengths

  3. Areas for Development

  4. Please give any final comments or suggestions for 's assessment.