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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 demonstrate a sense of responsibility and commitment to public trust.
  1. You consistently keep commitments.
  1. You communicate an understanding of the other person's interests, needs and concerns.
  1. You deliver on promises made.
  1. You are trustworthy; is someone that can be trusted.
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. You come across as comfortable and effective as a public speaker
  1. You communicate with department leadership
  1. You are willing to give feedback to others even if that feedback is critical of their approach.
  1. You deliver messages with energy, enthusiasm, and conviction.
  1. I communicate concepts and ideas to others.
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 demonstrate enthusiasm and a willingness to learn new skills and knowledge
  1. You seek opportunities for professional development.
  1. You seek opportunities for continuous learning.
  1. You encourage employees to take courses relevant to their job.
  1. You are contributing fully to the extent of your skills
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 understand what others need.
  1. You develop a good rapport with others.
  1. You have excellent influencing/negotiating skills.
  1. You persuade others to consider alternative points of view.
  1. You seek to obtain consensus or compromise.
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. I create a framework to support innovation.
  1. You encourage a search for radical innovation opportunities to obtain major breakthroughs.
  1. You value diverse opinions among team members.
  1. You fine-tune innovative strategies to maximize resource utilization and achieve desired outcomes.
  1. You celebrate innovative achievements publicly to motivate others and reinforce the importance of 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 assist others in understanding changes to the organization.
  1. You adopt changes to set and example for others to follow.
  1. I inspire others to accept the recent changes.
  1. I inspire others to accept changes.
  1. I develop plans for following through on the changes.
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 seek to reduce ambiguity in messaging and documents.
  1. You avoid stating unclear or conflicting goals.
  1. You write clear job descriptions for positions in the organization.
  1. You clearly explains responsibilities to individuals.
  1. You communicate ideas and facts clearly and effectively in writing.
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. I tailor solutions to meet the specific needs of each client.
  1. I build long term relationships with clients.
  1. You use feedback from the client to help improve the client's experience.
  1. You help clients feel they are receiving services tailored specifically to their needs.
  1. You manage client accounts with high degree of competence.
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 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 set and clearly communicate expectations, performance goals, and measurements to others
  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 monitor spending.
  1. You effectively manage appropriations, reporting, purchases, expenditures, payrolls, and staff.
  1. You develop budgets and plans for various programs and initiatives.
  1. You are effective in using company's resources.
  1. You develop of the department's annual budget.
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 persuade others to follow the Company's vision.
  1. You influence the attitudes and behaviors of subordinates to match the department's vision.
  1. You can establish an inspiring and strategic vision for the department.
  1. I create a clear and inspiring vision statement that outlines the desired future for the company.
  1. You understand the vision of the Company and promote it ahead of any self-interests.
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.