Recognition- 360 Degree Feedback Survey Sample #8

Questionnaires 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)

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. Recognizes individuals for a specific outstanding achievement.
  1. Reinforces and rewards employees for accomplishing necessary goals.
  1. Says "thank you" to show appreciation for work of others.
  1. Recognizes the abilities and skills of self and others
  1. Finds opportunities to recognize others.


Agree Unsure Disagree N/A
  1. Keeps their word and does what they say they will do.
  1. Creates a consistent process for prioritizing work.
  1. Keeps supervisor informed of recent events.
  1. Defines roles, rights, and responsibilities of employees.
  1. Acts like an owner when they make decisions.

Emotional Intelligence

Agree Unsure Disagree N/A
  1. Able to understand others' points of view.
  1. Is attentive to emotional cues and interprets others' feelings correctly.
  1. Helps employees to resolve conflicts, communicate clearly, and work together to solve problems.
  1. Is able to express themselves clearly.
  1. Is able to manage their own emotions.

Persuasion and Influence

Agree Unsure Disagree N/A
  1. Communicates effectively with others.
  1. Able to express own goals and needs.
  1. Understanding what others need.
  1. Develops a good rapport with others.
  1. Seeks to obtain consensus or compromise.

Change Management

Agree Unsure Disagree N/A
  1. Supports the Company's efforts to implement changes.
  1. Adopts changes to set and example for others to follow.
  1. Addresses organizational and departmental resistance to changes.
  1. Supports new initiatives for organizational changes to improve effectiveness.
  1. Works cooperatively with others to implement changes.


Agree Unsure Disagree N/A
  1. Is planful and organized.
  1. Takes a lot of pride in their work.
  1. Keeps themselves and others focused on constant improvement.
  1. Demonstrates the analytical skills to do their job.
  1. Can be counted on to add value wherever they are involved.

Interpersonal Skills

Agree Unsure Disagree N/A
  1. Values the opinions of others.
  1. Effectively manages conflicts by dealing with them directly and immediately
  1. Is trusted by peers and co-workers; others are willing to confide in him/her
  1. Adapts management style to meet the needs of the individual or situation.
  1. Expresses appreciation of other's work.

Co-worker Development

Agree Unsure Disagree N/A
  1. Gives others development opportunities through project assignments and increased job responsibilities
  1. Works to identify root causes of performance problems
  1. Adapts coaching and mentoring approach to meet the style or needs of individuals
  1. Takes immediate action on poor performance
  1. Provides ongoing feedback to co-workers on their development progress


Agree Unsure Disagree N/A
  1. Is flexible in responses.
  1. Establishes good working relationships with others.
  1. Conducts necessary preparations before engaging in negotiations.
  1. Influences others through rational argument and persuasion.
  1. Understands the expectations of other parties in the negotiation.

Global Perspective

Agree Unsure Disagree N/A
  1. Exemplifies the skills of a global worker.
  1. Excellent communication skills to conduct effective business with individuals from different cultures and/or countries.
  1. Understands how cultures differ and how these differences impact work behavior.
  1. Builds working relationships with others across cultures.
  1. Forms strong client relationships with international partners.

  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.