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Recognition- 360 Degree Feedback Survey Sample #1





360-Degree Feedback Survey

Surveys Measuring Recognition:
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)
Survey 13 (4-point scale; numbers; floating anchors)
Survey 14 (4-point scale; N/A)
Instructions:

[Company] is conducting a 360-Degree Feedback Assessment developed by HR-Survey for selected managers.

You have been selected to provide feedback on the employee listed above. Your feedback is an important part of our company's leadership development process and this survey 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 questions below, think about your experiences working with this employee over the last twelve months. The effectiveness of this development tool is dependent on your honest, forthright and constructive responses so please bear this in mind as you answer each question. Your responses will be aggregated with the responses received from others and discussed with the employee to foster growth and on-going 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.

Competencies Included:
Recognition, Attitude, Creativity, Self Management, Supervisory Skills, Clarity, Responsible, Customer Focus, Conflict Management, Planning
Sample Result Document:
Sample Results
Your feedback is valuable in helping the individual to understand how they are perceived and experienced by others and the impact their behavior has on people in the organization with whom they interact. Feedback received also acknowledges strengths and identifies areas for development.

Use the form below to provide your feedback. Each field and comment box requires a response before you can SUBMIT your final feedback.

Please ensure that your submission is made between . The survey will only be available during these dates.

Thank you for your participation in the survey. We look forward to seeing the analysis of your responses and we are hoping for 100% participation.

Management Team
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Recognition

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Provides year-end awards and recognition.
  1. Maintains appropriate documentation regarding award recipients.
  1. Coordinates recognition activities at different levels and areas within the organization.
  1. Ensures that the recognition program is highly visible to the employees.
  1. Links recognition to the employee's professional development and growth.
If [Participant Name] were to make improvements in Recognition, what are your suggestions for how he/she can improve this?

Attitude

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Sets a positive tone for the department and team.
  1. Gives credit to individuals for their ideas and input, regardless of role or seniority.
  1. Always undertakes projects with expectations of success.
  1. Highlights progress and effort, even if outcomes are still emerging.
  1. Goes above and beyond when the team or organization needs extra support.
If [Participant Name] were to make improvements in Attitude, what are your suggestions for how he/she can improve this?

Creativity

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Participates in industry networks to stay attuned to emerging ideas.
  1. Creates an atmosphere where creative energy thrives.
  1. Supports idea development from spark to implementation.
  1. Provides thoughtful feedback to refine and improve new ideas or products.
  1. Generates original concepts that challenge conventional thinking.
If [Participant Name] were to make improvements in Creativity, what are your suggestions for how he/she can improve this?

Self Management

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Is aware of personal impact on others and adjusts behavior to create a positive leadership presence.
  1. Analyzes own reactions on the spot to ensure that communication does not appear to be driven by anger.
  1. Does not allow own emotions to interfere with the performance of others.
  1. Sets an example for associates during stressful periods by maintaining a positive, can-do attitude.
  1. Analyzes interpersonal problems instead of reacting to them.
If [Participant Name] were to make improvements in Self Management, what are your suggestions for how he/she can improve this?

Supervisory Skills

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Instructs employees on the proper way to perform tasks.
  1. Coaches subordinates in how to make good decisions.
  1. Spends time to actively listen to the grievance.
  1. Coaches and mentors others to achieve higher performance levels.
  1. Conducts regular performance management sessions.
If [Participant Name] were to make improvements in Supervisory Skills, what are your suggestions for how he/she can improve this?

Clarity

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Clearly defines work objectives for employees.
  1. Avoids stating unclear or conflicting goals.
  1. Avoids creating ambiguity or mixed messages.
  1. Communicates with clarity and efficiency.
  1. Checks details thoroughly.
If [Participant Name] were to make improvements in Clarity, what are your suggestions for how he/she can improve this?

Responsible

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Acts as a resource without removing individual responsibility.
  1. Sets a good example
  1. Works in a way that makes others want to work with her/him.
  1. ...takes personal responsibility for results.
  1. Responsible for setting the vision of the department.
If [Participant Name] were to make improvements in Responsible, what are your suggestions for how he/she can improve this?

Customer Focus

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Attends to the customer's needs in addition to the specific needs of the project.
  1. Is friendly and courteous.
  1. Takes prompt action to address a customer concern or complaint.
  1. Ensures customers' expectations are met or exceeded.
  1. Is honest in all communication with the customers.
If [Participant Name] were to make improvements in Customer Focus, what are your suggestions for how he/she can improve this?

Conflict Management

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Influences attitudes, beliefs, and behaviors in a way that fosters resolution and cooperation.
  1. Translates abstract concerns into actionable steps, helping teams move from confusion to clarity.
  1. Combines different ideas and viewpoints.
  1. Revisits previously held assumptions or decisions when new information or perspectives emerge.
  1. Works with others as needed to facilitate resolution of conflicts.
If [Participant Name] were to make improvements in Conflict Management, what are your suggestions for how he/she can improve this?

Planning

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Creates to-do lists to make sure nothing is missed.
  1. Develops good plans used for logistics.
  1. Accurately estimates the amount of materials/supplies needed for the project.
  1. Determines what supplies/equipment will be needed for the department.
  1. Determines staffing needs for the project/department.
If [Participant Name] were to make improvements in Planning, what are your suggestions for how he/she can improve this?

  1. What are [Participant Name Here]'s greatest strengths demonstrated this year?


  2. What are [Participant Name Here]'s areas for development?


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