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 are trustworthy; is someone that can be trusted.
  1. You work in a way that makes others want to work with you.
  1. You build and maintain the trust of others.
  1. You deliver on promises made.
  1. You consistently keep commitments.
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 have the confidence to communicate effectively to all levels (from ceo down) of the organization, external customers, suppliers, as well as the senior counsel of other companies.
  1. You an effective listener who is responsive to information needs.
  1. You communicate effectively with all levels of the organization.
  1. You communicate with department leadership
  1. You give clear and convincing presentations.
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 keep yourself up-to-date of technical/professional issues
  1. You seek opportunities for continuous learning.
  1. You allow employees to fully participate in employee training and professional development.
  1. You quickly acquire and apply new knowledge and skills when needed
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 communicate effectively with others.
  1. You seek to obtain consensus or compromise.
  1. You develop a good rapport with others.
  1. You ensure stakeholders are involved in the decision making process.
  1. You attempt to persuade others rather than simply control them.
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 implement best practices within the department.
  1. You analyze current procedures and identify opportunities for improvement.
  1. You foster a creative and innovative work environment.
  1. You suggest new ideas at meetings.
  1. You encourage open communication to ensure that all proposals are considered.
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. I am a leading force driving changes.
  1. You are effective in dealing with ambiguous and challenging situations.
  1. You work cooperatively with others to implement changes.
  1. I inspire others to want to change.
  1. I am able to get team members to change their attitudes.
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 are clear about goals that need to be achieved.
  1. You provide a clear vision for the future.
  1. You adjust communication methods to the needs of the audience.
  1. You seek to reduce ambiguity in messaging and documents.
  1. You are clear about the roles and duties of team members.
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 look for opportunities that have a positive impact on Clients.
  1. I exceed expectations of the clients.
  1. You use client feedback to help improve products and services.
  1. You create high quality products for the clients.
  1. You prioritize client issues to tackle the most pressing needs first.
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 adapt coaching and mentoring approach to meet the style or needs of individuals
  1. You give others development opportunities through project assignments and increased job responsibilities
  1. You take immediate action on poor performance
  1. You work to identify root causes of performance problems
  1. You set and clearly communicate expectations, performance goals, and measurements to others
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 monitor expenses and verify the need for items purchased.
  1. You develop budgets and plans for various programs and initiatives.
  1. You provide budgeting and accounting support to the Company.
  1. You ensure others follow the correct rules and regulations on fiscal matters.
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 communicate a vision of where the Company needs to be in the future.
  1. You understand the vision of the Company and promote it ahead of any self-interests.
  1. You persuade others to follow the Company's vision.
  1. You express the Company vision in a way that is easily understood and adopted by employees.
  1. You lead employees in new directions.
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.