Strategic Insight- 360 Degree Feedback Survey Sample #8

Questionnaires Measuring Strategic Insight:
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 .

Strategic Insight

Agree Unsure Disagree N/A
  1. Maintains knowledge of current trends in the industry.
  1. Analyzes unique issues or problems impacting the Company.
  1. Analyzes records and reports to obtain insight into potential issues and trends.
  1. Formulates policies and strategies for addressing the Company's important challenges.
  1. Identifies potential problems before they become critical incidents.


Agree Unsure Disagree N/A
  1. Understands the use of [Company] products and services.
  1. Follows existing procedures and processes.
  1. Understands the "basics" as to how [Company] functions/operates.
  1. Understands how decisions impact other business units beyond their immediate department of work group.
  1. Expresses loyalty and dedication to [Company] in interactions with others.

Cultural Awareness

Agree Unsure Disagree N/A
  1. Hires individuals with different cultural backgrounds for the department.
  1. Maintains an inclusive work environment that maximizes the talents of others in achieving goals.
  1. Recognizes and values individual and cultural differences.
  1. Understands the impact that our culture may have on interactions between individuals.
  1. Encourages a work environment where individual differences are valued.


Agree Unsure Disagree N/A
  1. ...Produce Quality
  1. Sets a high standard for job performance.
  1. ...Overall Performance
  1. Has great overall performance
  1. Able to organize work.


Agree Unsure Disagree N/A
  1. Accepts setbacks and challenges as improvement opportunities
  1. Completes work to a high technical standard
  1. Allocates resources as needed to accomplish organizational goals.
  1. Is determined to complete tasks regardless of obstacles that may occur.
  1. Completes work promptly and efficiently.

Results Oriented

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


Agree Unsure Disagree N/A
  1. Participates in safety training when offered.
  1. Performs work safely.
  1. Develops a sustainable safety culture.
  1. Is aware of OSHA safety guidelines.
  1. Encourages others to work safely.


Agree Unsure Disagree N/A
  1. Conducts regular performance appraisals and feedback.
  1. Provides clear, motivating, and constructive feedback.
  1. Helps employees to maintain high personal standards.
  1. Coaches employees in how to strengthen knowledge and skills to improve work performance.
  1. Addresses employee behavior problems effectively.

Conflict Management

Agree Unsure Disagree N/A
  1. Discusses conflict situations with supervisor.
  1. Helps employees to think through alternative ways to resolve conflict situations.
  1. Tries to understand others' point of view before making judgments
  1. Clearly expresses expectations to others.
  1. Deals effectively with employee grievances.

  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.