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

  • Attempts to persuade others rather than simply control them.
  • Seeks to obtain consensus or compromise.
  • Understanding what others need.
  • Able to express own goals and needs.
  • Communicates effectively with others.
If [Participant Name] were to make improvements in Persuasion and Influence, what are your suggestions for how he/she can improve this?


  • Effectively makes decisions
  • Motivates & supports others to gain skills
  • Drives and mobilizes others progress toward goals.
  • Makes effective decisions, even when under pressure.
  • Works quickly when faced with difficult problems.
If [Participant Name] were to make improvements in Action, what are your suggestions for how he/she can improve this?


  • Open to the suggestions of others.
  • Is easy to approach with ideas and opinions.
  • Accepts the views of others.
  • Shares past experiences with others as learning opportunities.
  • Looks to others for input.
If [Participant Name] were to make improvements in Feedback, what are your suggestions for how he/she can improve this?

Co-worker Development

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

Strategic Focus

  • Understands their role within the organization.
  • Understands & contributes to development of strategic goals.
  • Communicates goals and objectives to employees.
  • Sustains or achieves a competitive advantage for the organization by analyzing the best practices and lessons learned from other organizations.
  • Creates plans to develop and promote organizational and area strengths, as well as to address weaknesses.
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.