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. Communicates vision for the department and company.
  1. Implements long-term solutions to problems.
  1. Maintains knowledge of current trends in the industry.
  1. Understands the Company's strengths and weaknesses and uses this information to create optimal solutions to problems.
  1. Analyzes unique issues or problems impacting the Company.


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

Cultural Awareness

Agree Unsure Disagree N/A
  1. Recognizes and values individual and cultural differences.
  1. Maintains an inclusive work environment that maximizes the talents of others in achieving goals.
  1. Encourages a work environment where individual differences are valued.
  1. Shows respect in daily interactions
  1. Values the opinions of diverse groups and individual.


Agree Unsure Disagree N/A
  1. Effectively organizes resources and plans
  1. ...Produce Quality
  1. Listens and responds to issues and problems
  1. Has great overall performance
  1. Able to organize work.


Agree Unsure Disagree N/A
  1. Holds others to high standards of achievement.
  1. Uses established goals and performance measures to keep track of performance.
  1. Takes calculated risks.
  1. Demonstrates improvement in performance.
  1. Takes calculated risks to achieve higher levels of performance.

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. Explains the "whys" behind organizational objectives
  1. Demonstrates the personal confidence to "stay the course," even when faced with difficulty
  1. Provides clear expectations for employees.
  1. Stays focused on meeting the needs of customers.


Agree Unsure Disagree N/A
  1. Ensures that all supervisors are aware of regulatory and compliance measures.
  1. Encourages others to attend safety training.
  1. Is aware of OSHA safety guidelines.
  1. Ensures compliance with safety regulations.
  1. Develops a sustainable safety culture.


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

Conflict Management

Agree Unsure Disagree N/A
  1. Deals effectively with employee grievances.
  1. Discusses conflict situations with supervisor.
  1. Assists team members by helping them see the other point of view.
  1. Tries to understand others' point of view before making judgments
  1. Identifies and takes steps to prevent potential confrontations.

  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.