Trustworthy - 360 Degree Feedback Survey Sample #2





Questionnaires Measuring Trustworthiness:
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)
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.


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 are trustworthy; is someone that can be trusted.
  1. You take ownership, deliver on commitments
  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. You deliver well-prepared, informed, poised and succinct presentations.
  1. You communicate effectively with all levels of the organization.
  1. I am willing to express my concerns to colleagues.
  1. I face the person when speaking or listening to engage in direct communication.
  1. You use software, graphics, or other aids to clarify complex or technical reports.
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 develop a good rapport with others.
  1. You are able to express own goals and needs.
  1. You communicate effectively with others.
  1. You seek to obtain consensus or compromise.
  1. You understand what others need.
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 encourage open communication to ensure that all proposals are considered.
  1. You search for opportunities and innovative ways to improve the organization.
  1. You foster a creative and innovative work environment.
  1. You find creative ways to get things done with limited resources.
  1. You create improved methods or solutions for meeting goals and objectives.
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 address organizational and departmental resistance to changes.
  1. I facilitate change with minimal resistance.
  1. I inspire others to accept changes.
  1. You adopt changes to set and example for others to follow.
  1. I am a leading force driving 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 communicate ideas and facts clearly and effectively in writing.
  1. You clearly explain the vision and goals of the company.
  1. You avoid stating unclear or conflicting goals.
  1. You use appropriate grammar and tense in communications.
  1. You communicate with clarity and efficiency.
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 am responsive to client needs.
  1. You view client satisfaction as an everyday priority.
  1. You put client's needs first.
  1. I am committed to resolving client issues in a positive way.
  1. You get feedback from the client on a weekly basis.
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 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 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 effectively manage appropriations, reporting, purchases, expenditures, payrolls, and staff.
  1. You are effective in using company's resources.
  1. You provide budgeting and accounting support to the Company.
  1. You monitor expenses and verify the need for items purchased.
  1. You monitor spending.
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. I craft a compelling roadmap for the department's future.
  1. You express the Company vision in a way that is easily understood and adopted by employees.
  1. You turn the department's vision into defined objectives and a strategic framework.
  1. I shape the department's vision into actionable goals.
  1. I establish a clear vision for where the company should be heading.
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.