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)

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. Stays focused on meeting the needs of customers.
  1. Provides clear expectations for employees.
  1. Demonstrates the personal confidence to "stay the course," even when faced with difficulty
  1. Inspires and motivates co-workers to be productive and energetic at work
  1. Encourages a high-energy, fun work environment and coaches others on how to do the same


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


Agree Unsure Disagree N/A
  1. Suggests new ideas at meetings.
  1. Offers constructive improvements to existing systems.
  1. Implements best practices within the department.
  1. Builds upon the ideas and solutions of others.
  1. Analyzes current procedures and identifies opportunities for improvement.

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. Creates a sense of urgency among the store team members to complete activities, which drive sales.
  1. Coordinates all department activities into a cohesive team effort.
  1. Maintains persistence and dedication to achieving results.
  1. Takes immediate action toward goals.


Agree Unsure Disagree N/A
  1. Clarifies problems and their causes to help employees correct them.
  1. Maintains clarity in goals and objectives.
  1. Checks details thoroughly.
  1. Avoids stating unclear or conflicting goals.
  1. Makes sure goals and objectives are clearly and thoroughly explained and understood.

Managing Risk

Agree Unsure Disagree N/A
  1. Able to adapt quickly to changing situations.
  1. Knows how to obtain desired results with minimal losses.
  1. Maintains open communication with other departments.
  1. Rewards innovative experiments to try new ideas.
  1. Effectively responds to critical situations to reduce potential for losses.

Client Focus

Agree Unsure Disagree N/A
  1. Satisfies client needs.
  1. Obtains feedback to ensure client needs are being met.
  1. Is pro-active in dealing with clients and addressing their needs.
  1. Forms strong client relationships
  1. Looks for opportunities that have a positive impact on Clients.


Agree Unsure Disagree N/A
  1. Helps employees to maintain high personal standards.
  1. Meets regularly with employees to coach them on areas that will enhance their performance
  1. Addresses employee behavior problems effectively.
  1. Helps employees to understand responsibilities, authority, and expectations.
  1. Coaches employees in how to strengthen knowledge and skills to improve work performance.

Business Acumen

Agree Unsure Disagree N/A
  1. Considers impact of actions on other areas of the organization.
  1. Applies the knowledge of work processes to influence the achievement of business goals
  1. Exhibits behavior that is consistent with the vision, mission, and core values 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. Formulates strategies and action plans to ensure successful completion of goals and objectives.
  1. Anticipates business cycles and trends and makes adjustments in a timely manner.
  1. Analyzes records and reports to obtain insight into potential issues and trends.
  1. Analyzes unique issues or problems impacting the Company.
  1. Implements long-term solutions to problems.


Agree Unsure Disagree N/A
  1. Works to eliminate unnecessary work or barriers that get in others' way.
  1. Builds open and trusting relationships.
  1. Visibly supports and encourages diversity in style and background.
  1. Treats all people fairly and with respect.
  1. Contributes to a positive and fun work environment.


Agree Unsure Disagree N/A
  1. Leads employees in new directions.
  1. Clearly articulates a vision for his/her work and inspires others to support it
  1. Expresses the Company vision in a way that is easily understood and adopted by employees.
  1. Behaves in a way that is consistent with business values & code of conduct
  1. Understands the vision of the Company and promotes it ahead of any self-interests.

  1. Overall, please rate the effectiveness of .

  2. Strengths

  3. Areas for Development

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