Technology Use/Management - 360 Degree Feedback Survey Sample #8

Questionnaires Measuring Technology Use/Management:
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 .

Technology Use/Management

Agree Unsure Disagree N/A
  1. Supports employee training and development initiatives regarding implementation of technology.
  1. Applies complex rules and regulations to maintain optimal system performance.
  1. Uses technology in decision making and problem solving.
  1. Maximizes the use of new technology to deliver products and services.
  1. Adopts the implementation of new technology into the workplace.

Passion To Learn

Agree Unsure Disagree N/A
  1. Enjoys learning new skills and techniques.
  1. Takes initiative for own learning and development.
  1. Constantly enhances product knowledge through experimentation and play.
  1. Exhibits willingness to upgrade skills through additional training and education.
  1. Inspires others to learn new things.

Continual Learning

Agree Unsure Disagree N/A
  1. Pursues learning that will enhance job performance.
  1. Shares best practices with others and learns from others.
  1. Is open to new ideas and concepts.
  1. Builds on their strengths while addressing their weaknesses.
  1. Pursues professional development opportunities when they arise.

Continual Improvement

Agree Unsure Disagree N/A
  1. Encourages an employee culture of continuous improvement to seek out better ways of doing things.
  1. Looks for ways to expand and learn new job skills.
  1. Searches for new methods, techniques, and processes that increase efficiency and reduce costs.
  1. Promotes training and development opportunities to enhance job performance.
  1. Analyzes processes to determine areas for improvement.

Persuasion and Influence

Agree Unsure Disagree N/A
  1. Able to express own goals and needs.
  1. Communicates effectively with others.
  1. Persuades others to consider alternative points of view.
  1. Understanding what others need.
  1. Attempts to persuade others rather than simply control them.


Agree Unsure Disagree N/A
  1. Goal Setting
  1. Makes sure that I have a clear idea of our group's goals.
  1. Conducts timely follow-up; keeps others informed on a need to know basis.
  1. Establishes and documents goals and objectives.
  1. Sets high expectations and goals; encourages others to support the organization.

Results Oriented

Agree Unsure Disagree N/A
  1. Works toward achievement of goals even when confronted with obstacles.
  1. Explains the "whys" behind organizational objectives
  1. Provides clear expectations for employees.
  1. Helps others when free-time is available.
  1. Stays focused on meeting the needs of customers.


Agree Unsure Disagree N/A
  1. Demonstrates the analytical skills to do their job.
  1. Can be counted on to add value wherever they are involved.
  1. Is planful and organized.
  1. Takes a lot of pride in their work.
  1. Produces high quality work.


Agree Unsure Disagree N/A
  1. Holds herself / himself accountable to goals / objectives
  1. Behavior is ethical and honest.
  1. Works in a way that makes others want to work with her/him.
  1. Responsible for setting the vision of the department.
  1. Is a person you can trust.


Agree Unsure Disagree N/A
  1. Supports the efforts of other employees in implementing solutions to problems.
  1. Works effectively with people from other departments.
  1. Treats others with respect and dignity.
  1. Works across boundaries within the organization.
  1. Consistently demonstrates ability and willingness to trust others.


Agree Unsure Disagree N/A
  1. Able to identify the needs of the department before a major change.
  1. Able to look ahead (beyond the present) when addressing the work/needs of the department.
  1. Works in an organized manner
  1. Anticipates obstacles and ways to overcome them.
  1. Delegates role to team members to accomplish goals.

  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.