Quality - 360 Degree Feedback Survey Sample #8

Questionnaires Measuring Quality:
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 .


Agree Unsure Disagree N/A
  1. Encourages others to achieve high quality standards.
  1. Holds employees accountable for their quality of work.
  1. Encourages others to produce the highest quality work products.
  1. Always strives to produce the highest quality work products.
  1. Corrects issues in a timely manner.


Agree Unsure Disagree N/A
  1. Seeks and utilizes opportunities for continuous learning and self-development.
  1. Goes above and beyond the stated goals.
  1. Takes the initiative to change the direction or course of events.
  1. Prepares for unexpected contingencies.
  1. Immediately works to complete goals well before their deadline.

Commitment To Result

Agree Unsure Disagree N/A
  1. Willing to do whatever it takes-not afraid to have to put in extra effort.
  1. Takes immediate action toward goals.
  1. Coordinates all department activities into a cohesive team effort.
  1. Able to focus on a task even when working alone.
  1. Encourages commitment in others to obtain results.


Agree Unsure Disagree N/A
  1. Clarifies problems and their causes to help employees correct them.
  1. Maintains clarity in goals and objectives.
  1. Attends to the important details of a job or task.
  1. Makes sure goals and objectives are clearly and thoroughly explained and understood.
  1. Checks details thoroughly.

Managing Risk

Agree Unsure Disagree N/A
  1. Recognizes that small changes may snowball into major events.
  1. Knows how to obtain desired results with minimal losses.
  1. Avoids maintaining the status quo (or standard operating procedures) when addressing new and influential situations.
  1. Seeks to maintain the long-term viability of the Company.
  1. Bases decisions on patterns found in fluid/changing information.


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

Supervisory Skills

Agree Unsure Disagree N/A
  1. Encourages employees to achieve their full potential.
  1. Is aware of the unique strengths of each employee.
  1. Maintains good working relationships with employees.
  1. Provides constructive, ongoing feedback.
  1. Delegates effectively.


Agree Unsure Disagree N/A
  1. Encourages dynamic growth opportunities.
  1. Able to adapt the department to changing business demands and climate.
  1. Finds unique ways to go around barriers to success.
  1. Excellent at managing relationships with stakeholders.
  1. Exhibits determination and passion in completion of goals.


Agree Unsure Disagree N/A
  1. Clearly articulates a vision for his/her work and inspires others to support it
  1. Demonstrates consistency between words and actions
  1. Persuades others to follow the Company's vision.
  1. Behaves in a way that is consistent with business values & code of conduct
  1. Creates a common vision for others.

  1. Overall, please rate the effectiveness of .

  2. Strengths

  3. Areas for Development

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