Persuasion and Influence - 360 Degree Feedback Survey Sample #10

360 Feedback Survey

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)
Survey 10 (Comment boxes only)
Survey 11 (Single rating per competency)
Survey 12 (Slide-bar scale)

Thank you for providing feedback for the recipient above. As you respond, please draw on your first-hand experience with this individual in the past 12 months. Rate each item using the scale shown. If you don't feel you have enough first-hand information to rate a certain item, please choose the Not Applicable option. Comments can be very helpful; at a minimum where you give a particularly high or low rating, please share your reasons in the comment section for that competency. Your responses will be compiled with feedback from others and presented to the recipient to help guide their ongoing development.

Partially completed forms can be saved by using the Save/Still Working button at the bottom of the page. You may return at a later time to complete/edit the form. Your saved responses will be shown each time you re-visit the feedback form. When you are certain that you have completed your responses and will be not making any changes, click the Complete button.

Persuasion and Influence

  • Ensures stakeholders are involved in the decision making process.
  • Communicates effectively with others.
  • Understanding what others need.
  • Attempts to persuade others rather than simply control them.
  • Persuades others to consider alternative points of view.
If [Participant Name] were to make improvements in Persuasion and Influence, what are your suggestions for how he/she can improve this?


  • Motivates & supports others to gain skills
  • Drives and mobilizes others progress toward goals.
  • Displays high energy and enthusiasm on consistent basis.
  • Makes effective decisions, even when under pressure.
  • Effectively makes decisions
If [Participant Name] were to make improvements in Action, what are your suggestions for how he/she can improve this?


  • Seeks feedback to enhance performance.
  • Asks others for their ideas and opinions.
  • Looks to others for input.
  • Considers other's opinion and suggestions.
  • Open to the suggestions of others.
If [Participant Name] were to make improvements in Feedback, what are your suggestions for how he/she can improve this?

Co-worker Development

  • Works to identify root causes of performance problems
  • Provides ongoing feedback to co-workers on their development progress
  • Gives others development opportunities through project assignments and increased job responsibilities
  • Sets and clearly communicates expectations, performance goals, and measurements to others
  • Adapts coaching and mentoring approach to meet the style or needs of individuals
If [Participant Name] were to make improvements in Co-worker Development, what are your suggestions for how he/she can improve this?

Strategic Focus

  • Communicates goals and objectives to employees.
  • Looks for opportunities to enhance contributions to the bottom line.
  • Sustains or achieves a competitive advantage for the organization by analyzing the best practices and lessons learned from other organizations.
  • Understands their role within the organization.
  • Focuses attention on treating the causes of problems rather than simply addressing the symptoms.
If [Participant Name] were to make improvements in Strategic Focus, what are your suggestions for how he/she can improve this?
Overall, please rate the effectiveness of [Participant Name Here].


Areas for Development

Please give any final comments or suggestions for [Participant Name Here]'s assessment.