Planning- 360 Degree Feedback Survey Sample #8

Questionnaires Measuring Planning:
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)

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.

Sample Result Document:
Sample Results
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 .


Agree Unsure Disagree N/A
  1. Able to identify the needs of the department before a major change.
  1. Anticipates obstacles and ways to overcome them.
  1. Delegates role to team members to accomplish goals.
  1. Able to look ahead (beyond the present) when addressing the work/needs of the department.
  1. Works in an organized manner

Strategic Focus

Agree Unsure Disagree N/A
  1. Understands & contributes to development of strategic goals.
  1. Looks for opportunities to enhance contributions to the bottom line.
  1. Monitors performance of each market within the Area, utilizing reports to ensure sales growth, cost management, and profitability targets are met.
  1. Creates plans to develop and promote organizational and area strengths, as well as to address weaknesses.
  1. Understands their role within the organization.


Agree Unsure Disagree N/A
  1. Gets the job done.
  1. Makes effective decisions, even when under pressure.
  1. Does whatever it takes (within reason) to get the job done.
  1. Motivates & supports others to gain skills
  1. Is not afraid to take corrective action when necessary.

Professional Development

Agree Unsure Disagree N/A
  1. Allows employees to fully participate in employee training and professional development.
  1. Contributing fully to the extent of their skills
  1. Demonstrate enthusiasm and a willingness to learn new skills and knowledge
  1. Seeks opportunities for professional development.
  1. Seeks opportunities for continuous learning.


Agree Unsure Disagree N/A
  1. Starts meetings on time.
  1. Arrives to meetings on time.
  1. Responds to requests for information in a timely manner.
  1. Invoices clients on a timely basis.
  1. Starts the workday when scheduled.


Agree Unsure Disagree N/A
  1. Is ready to offer help
  1. Takes responsibility for things that go wrong
  1. Sets an example for others to follow
  1. Makes you feel enthusiastic about your work
  1. Delegate tasks effectively

Supervisory Skills

Agree Unsure Disagree N/A
  1. Treats all staff equitably.
  1. Appropriately recognizes and rewards employees.
  1. Is aware of the unique strengths of each employee.
  1. Delegates effectively.
  1. Provides constructive, ongoing feedback.


Agree Unsure Disagree N/A
  1. Uses appropriate techniques to solve problems.
  1. Identifies problems and issues needing resolution.
  1. Implements data validation techniques and methods.
  1. Asks the "right" questions to size up or evaluate situations.
  1. Selects the appropriate techniques for analysis.

Time Management

Agree Unsure Disagree N/A
  1. Leaves time in the schedule for unplanned contingencies.
  1. Uses agendas when chairing or facilitating meetings.
  1. Prioritizes new tasks according to their relative importance.
  1. Does not procrastinate.
  1. Does not become flustered by deadlines and timelines.

Juggling Multiple Responsibilities

Agree Unsure Disagree N/A
  1. Assigns tasks based on skills of team members.
  1. Assesses current capabilities before committing to new requests from customers.
  1. Ranks the importance of tasks to make sure critical tasks are completed first.
  1. Uses a scheduler/planner to keep tasks organized and on time.
  1. Ensures that assignments are prioritized according to the needs of the department/company.

Technology Use/Management

Agree Unsure Disagree N/A
  1. Adopts the implementation of new technology into the workplace.
  1. Identifies gaps between actual and needed technical competencies and provides recommendations for required training.
  1. Proficient in the use of technical systems and processes.
  1. Uses technology in decision making and problem solving.
  1. Applies complex rules and regulations to maintain optimal system performance.


Agree Unsure Disagree N/A
  1. Points out behaviors in others that may be unsafe.
  1. Develops a sustainable safety culture.
  1. Is aware of OSHA safety guidelines.
  1. Creates accurate and effective measures of safety.
  1. Identifies and addresses safety needs.

  1. Overall, please rate the effectiveness of [Participant Name Here].

  2. Strengths

  3. Areas for Development

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