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Trustworthy - 360 Degree Feedback Survey Sample #2





Questionnaires Measuring Trustworthy:
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)
Survey 13 (4-point scale; numbers; floating anchors)
Survey 14 (4-point scale; N/A)
Self-Assessment Instructions

You have been asked to complete a self-assessment questionnaire form (shown below). You will also receive feedback from others such as your peers, direct reports and manager. Feedback is an important part of our company's leadership development process and this survey 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 questions below, think about your experiences as an employee over the last twelve months and the goals you were asked to achieve. The effectiveness of this development tool is dependent on your honest, forthright and constructive responses so please bear this in mind as you answer each question. Your responses will become part of the assessment process to foster your growth and on-going development.

Competencies Included:
Trustworthy, Communication Skills, Professional Development, Persuasion and Influence, Innovation, Change Management, Clarity, Client Focus, Co-worker Development, Fiscal Management, Vision
Sample Result Document:
Sample Results
Partially completed forms can be saved by using the Save/Still Working button at the bottom of the page. You may return at a later time to complete/edit the form. Your saved responses will be shown each time you re-visit the feedback form. When you are certain that you have completed your responses and will be not making any changes, click the Complete button.

Please ensure that your submission is made between . The survey will only be available during these dates.
Edit this Survey
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Trustworthy

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You seek to mitigate grievances by clarifying intentions and finding suitable remedies.
  1. You communicate an understanding of the other person's interests, needs and concerns.
  1. You demonstrate congruence between statements and actions.
  1. You consistently keep commitments.
  1. You are a person others can count on.
What are your suggestions for how you can make improvements
in Trustworthy?

Communication Skills

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. I maintain a formal and respectful tone, avoid using of slang or overly casual language.
  1. I respond to critical concerns of stakeholders.
  1. I facilitate seamless communication across all management levels.
  1. You deliver information in a clear, concise, and logical manner.
  1. I mark my status as "available" to signal I am open for communication.
What are your suggestions for how you can make improvements
in Communication Skills?

Professional Development

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You are contributing fully to the extent of your skills
  1. You quickly acquire and apply new knowledge and skills when needed
  1. You allow employees to fully participate in employee training and professional development.
  1. You seek opportunities for professional development.
  1. You demonstrate enthusiasm and a willingness to learn new skills and knowledge
What are your suggestions for how you can make improvements
in Professional Development?

Persuasion and Influence

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You leverage industry insights and benchmarks to support persuasive arguments and strategic recommendations.
  1. I identify cultural, political, or organizational sensitivities before making a case, avoiding missteps that could undercut credibility.
  1. You use clear examples and measurable results to support arguments, making complex issues more tangible.
  1. You earn the respect of employees by consistently doing what you ask of them - modeling the behavior you wish to see.
  1. You are able to deliver extemporaneous speeches to influence employees.
What are your suggestions for how you can make improvements
in Persuasion and Influence?

Innovation

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You use unconventional approaches to solve problems.
  1. You challenge existing work processes/products to enhance value.
  1. You offer solutions to problems when talking with clients.
  1. You embrace innovation as a way to improve how you do things.
  1. I create a framework to support innovation.
What are your suggestions for how you can make improvements
in Innovation?

Change Management

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You clearly communicate the need for change explaining why it is necessary.
  1. You adapt strategy and leadership to meet emerging demands.
  1. I introduce structural changes to the team/department.
  1. I help teams and department overcome hurdles to achieve necessary changes.
  1. You anticipate changes that radical decisions may have on the department.
What are your suggestions for how you can make improvements
in Change Management?

Clarity

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You clarify problems and their causes to help employees correct them.
  1. You clearly define work objectives for employees.
  1. You avoid creating ambiguity or mixed messages.
  1. You seek to reduce ambiguity in messaging and documents.
  1. You check details thoroughly.
What are your suggestions for how you can make improvements
in Clarity?

Client Focus

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You get feedback from the client on a weekly basis.
  1. You consistently exceed client expectations.
  1. I understand what resources are needed to meet client needs.
  1. I keep the client informed of all progress.
  1. I actively listen to concerns from clients.
What are your suggestions for how you can make improvements
in Client Focus?

Co-worker Development

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You take immediate action on poor performance
  1. You work to identify root causes of performance problems
  1. You give others development opportunities through project assignments and increased job responsibilities
  1. You provide ongoing feedback to co-workers on your development progress
  1. You adapt coaching and mentoring approach to meet the style or needs of individuals
What are your suggestions for how you can make improvements
in Co-worker Development?

Fiscal Management

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You are effective in using company's resources.
  1. You develop of the department's annual budget.
  1. You ensure others follow the correct rules and regulations on fiscal matters.
  1. You provide budgeting and accounting support to the Company.
  1. You monitor expenses and verify the need for items purchased.
What are your suggestions for how you can make improvements
in Fiscal Management?

Vision

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You anticipate resistance and proactively address concerns while reinforce the vision's relevance.
  1. You maintain a consistent focus on long-term objectives, even when short-term pressures arise.
  1. I avoid mixed messages by ensuring verbal and non-verbal cues reflect the same priorities.
  1. I demonstrate conviction and enthusiasm when discussing the vision, energizing the team.
  1. I design a forward-thinking strategy to achieve the department's growth goals.
What are your suggestions for how you can make improvements
in Vision?


  1. Strengths


  2. Areas for Development


  3. Please give any final comments or suggestions for [Participant Name Here]'s assessment.