Vision- 360 Degree Feedback Survey Sample #8

Questionnaires Measuring Vision:
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 .


Agree Unsure Disagree N/A
  1. Works to support the strategy of [Company]
  1. Communicates the vision and strategy of [Company]
  1. Behaves in a way that is consistent with business values & code of conduct
  1. Clearly articulates a vision for his/her work and inspires others to support it
  1. Communicates a vision of where the Company needs to be in the future.


Agree Unsure Disagree N/A
  1. Works effectively with various personalities of team members.
  1. Handles changes easily.
  1. Is proactive and takes steps to prepare for changes in the workplace.
  1. Is flexible and open minded in dealing with others.
  1. Able to adjust to changing environments.

Bias for Action

Agree Unsure Disagree N/A
  1. Motivates others to achieve or exceed goals
  1. Seeks and utilizes opportunities for continuous learning and self-development.
  1. Identifies ways to simplify work processes and reduce cycle times
  1. Completes work on time
  1. Coach others to foster an environment which can adapt quickly and willingly to rapid change.


Agree Unsure Disagree N/A
  1. Conducts appointments at scheduled start time.
  1. Starts the workday when scheduled.
  1. Maintains an efficient schedule of activities.
  1. Invoices clients on a timely basis.
  1. Arrives to meetings on time.


Agree Unsure Disagree N/A
  1. Anticipates problems and initiates plans to address them.
  1. Guides strategic initiatives to advance the department/organization.
  1. Initiates draft documents for the director.
  1. Acts quickly when an opportunity becomes available.
  1. Takes on extra projects after required work is completed.

Change Management

Agree Unsure Disagree N/A
  1. Facilitates change with minimal resistance.
  1. Adopts changes to set and example for others to follow.
  1. Works cooperatively with others to implement changes.
  1. Supports the Company's efforts to implement changes.
  1. Effective in implementing new organizational vision and values.

Commitment To Result

Agree Unsure Disagree N/A
  1. Encourages commitment in others to obtain results.
  1. Committed to the team.
  1. Conveys strong sense of own pride in Company to associates by creating a shared vision around sales and customer service.
  1. Willing to do whatever it takes-not afraid to have to put in extra effort.
  1. Able to focus on a task even when working alone.

Managing Risk

Agree Unsure Disagree N/A
  1. Accurately perceives potential risks in the workplace and initiates preventative measures.
  1. Attends risk management seminars and conferences.
  1. Creates a risk management strategy for the department.
  1. Tracks risks in a project.
  1. Develops appropriate strategies to minimize risks.

Business Acumen

Agree Unsure Disagree N/A
  1. Aware of regulations that impact our business.
  1. Exhibits behavior that is consistent with the vision, mission, and core values of the organization
  1. Anticipates marketplace opportunities and supports speed to market.
  1. Has a good understanding of liabilities and assets.
  1. Calculates return on investment (ROI) for various business projects.


Agree Unsure Disagree N/A
  1. Able to stay organized and focused using excellent planning skills.
  1. Adjusts plans as needed according to situational/strategic changes.
  1. Sets the appropriate sequence of tasks to ensure completion of the project.
  1. Able to develop logistics plans to move material through a multi-step supply chain.
  1. Understands the process for developing strategic plans for the organization.

  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.