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.

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 .

Results Oriented

Agree Unsure Disagree N/A
  1. Works toward achievement of goals even when confronted with obstacles.
  1. Encourages a high-energy, fun work environment and coaches others on how to do the same
  1. Provides clear expectations for employees.
  1. Does not become distracted by non-issues or interruptions.
  1. Inspires and motivates co-workers to be productive and energetic at work


Agree Unsure Disagree N/A
  1. Engages with new customers immediately.
  1. Looks for opportunities to move projects forward.
  1. Takes corrective action to rectify issues.
  1. Quickly comes to the aid of those who may need help.
  1. Initiates important conversation topics at meetings.


Agree Unsure Disagree N/A
  1. Offers constructive improvements to existing systems.
  1. Creates a safe environment for idea-sharing.
  1. Implements best practices within the department.
  1. Solves problems with insight and understanding.
  1. Builds upon the ideas and solutions of others.

Commitment To Result

Agree Unsure Disagree N/A
  1. Takes immediate action toward goals.
  1. Creates a sense of urgency among the store team members to complete activities, which drive sales.
  1. Able to focus on a task even when working alone.
  1. Coordinates all department activities into a cohesive team effort.
  1. Committed to the team.


Agree Unsure Disagree N/A
  1. Clearly explains the vision and goals of the company.
  1. Clearly defines work objectives for employees.
  1. Clearly explains responsibilities to individuals.
  1. Provides a clear vision for the future.
  1. Maintains clarity in goals and objectives.

Managing Risk

Agree Unsure Disagree N/A
  1. Aware of appropriate actions to minimize risks.
  1. Attends risk management seminars and conferences.
  1. Creates a risk management strategy for the department.
  1. Develops policies to address risk situations in the workplace.
  1. Committed to implementing rules and procedures to minimize risk.

Client Focus

Agree Unsure Disagree N/A
  1. Able to handle difficult clients.
  1. Has received good feedback from clients.
  1. Maintains up-to-date information regarding client products.
  1. Consistently exceeds client expectations.
  1. Builds trust with the client.


Agree Unsure Disagree N/A
  1. Coaches employees in how to strengthen knowledge and skills to improve work performance.
  1. Helps employees to understand responsibilities, authority, and expectations.
  1. Develops the skills and capabilities of others.
  1. Conducts regular performance appraisals and feedback.
  1. Meets regularly with employees to coach them on areas that will enhance their performance

Business Acumen

Agree Unsure Disagree N/A
  1. Describes and summarizes data.
  1. Has a good understanding of liabilities and assets.
  1. Applies the knowledge of work processes to influence the achievement of business goals
  1. Understands the dynamics of our industry.
  1. Keeps informed of current income and expenses.

Strategic Insight

Agree Unsure Disagree N/A
  1. Anticipates business cycles and trends and makes adjustments in a timely manner.
  1. Analyzes unique issues or problems impacting the Company.
  1. Implements long-term solutions to problems.
  1. Formulates policies and strategies for addressing the Company's important challenges.
  1. Maintains knowledge of current trends in the industry.


Agree Unsure Disagree N/A
  1. Contributes to a positive work environment.
  1. Builds open and trusting relationships.
  1. Treats all people fairly and with respect.
  1. Visibly supports and encourages diversity in style and background.
  1. Is gracious and professional in their interactions with others.


Agree Unsure Disagree N/A
  1. Understands the vision of the Company and promotes it ahead of any self-interests.
  1. Demonstrates consistency between words and actions
  1. Persuades others to follow the Company's vision.
  1. Develops action plans to align his/her work with the goals of the organization
  1. Works to support the strategy of [Company]

  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.