Results Oriented - 360 Degree Feedback Survey Sample #8

Results Oriented Questionnaires:
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.

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 .

Results Oriented

Agree Unsure Disagree N/A
  1. Encourages a high-energy, fun work environment and coaches others on how to do the same
  1. Does not become distracted by non-issues or interruptions.
  1. Stays focused on meeting the needs of customers.
  1. Demonstrates the personal confidence to "stay the course," even when faced with difficulty
  1. Provides clear expectations for employees.


Agree Unsure Disagree N/A
  1. Goes above and beyond the stated goals.
  1. Coach others to foster an environment which can adapt quickly and willingly to rapid change.
  1. Seeks and utilizes opportunities for continuous learning and self-development.
  1. Takes the initiative to change the direction or course of events.
  1. Takes action without being asked.


Agree Unsure Disagree N/A
  1. Challenges current procedures to develop other alternatives.
  1. Creates a safe environment for idea-sharing.
  1. Analyzes current procedures and identifies opportunities for improvement.
  1. Offers constructive improvements to existing systems.
  1. Encourages open communication to ensure that all proposals are considered.

Commitment To Result

Agree Unsure Disagree N/A
  1. Conveys strong sense of own pride in Company to associates by creating a shared vision around sales and customer service.
  1. Committed to the team.
  1. Able to focus on a task even when working alone.
  1. Maintains persistence and dedication to achieving results.
  1. Creates a sense of urgency among the store team members to complete activities, which drive sales.


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

Managing Risk

Agree Unsure Disagree N/A
  1. Knows how to obtain desired results with minimal losses.
  1. Responds appropriately to unexplained or unanticipated events.
  1. Maintains open communication with other departments.
  1. Recognizes that small changes may snowball into major events.
  1. Avoids maintaining the status quo (or standard operating procedures) when addressing new and influential situations.

Client Focus

Agree Unsure Disagree N/A
  1. Maintains strong relationships with clients.
  1. Obtains feedback to ensure client needs are being met.
  1. Ensures client commitments and requirements are met or exceeded
  1. Forms strong client relationships
  1. Is pro-active in dealing with clients and addressing their needs.


Agree Unsure Disagree N/A
  1. Coaches employees in how to strengthen knowledge and skills to improve work performance.
  1. Develops the skills and capabilities of others.
  1. Helps employees to understand responsibilities, authority, and expectations.
  1. Addresses employee behavior problems effectively.
  1. Provides clear, motivating, and constructive feedback.

Business Acumen

Agree Unsure Disagree N/A
  1. Understands complex issues and problems.
  1. Applies the knowledge of work processes to influence the achievement of business goals
  1. Considers impact of actions on other areas of the organization.
  1. Able to align resources to meet the business needs of the company.
  1. Asks the 'right' questions to size up or evaluate situations.

Strategic Insight

Agree Unsure Disagree N/A
  1. Identifies root causes of problems.
  1. Understands the Company's strengths and weaknesses and uses this information to create optimal solutions to problems.
  1. Implements long-term solutions to problems.
  1. Identifies potential problems before they become critical incidents.
  1. Formulates strategies and action plans to ensure successful completion of goals and objectives.


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


Agree Unsure Disagree N/A
  1. Communicates the vision and strategy of [Company]
  1. Communicates a vision of where the Company needs to be in the future.
  1. Expresses the Company vision in a way that is easily understood and adopted by employees.
  1. Understands the vision of the Company and promotes it ahead of any self-interests.
  1. Demonstrates consistency between words and actions

  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.