360 Degree Feedback Sample Questionnaire

Instructions

You have been selected to provide feedback for the individual listed above. Your feedback is an important part of Generic'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, unless you indicate otherwise.

Method of use: As part of the annual review process, managers will receive feedback from peers, subordinates, and leadership. 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 signout 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 how to respond to a particular item, you may leave it blank and proceed to the next item.

Read the statements below.



Communication Skills	Clear Strength	Capable and Effective Performance	Could benefit from Development	Needs Significant Improvement	N/A, cannot comment
Communicates effectively with colleagues and customers (Click here to add a comment)
Checks for understanding throughout conversations or group presentations/discussions (Click here to add a comment)
Delivers effective presentations (Click here to add a comment)
Explains reasons behind decisions and actions (Click here to add a comment)
Delivers difficult/sensitive messages to co-workers in an appropriate manner (Click here to add a comment)
Comment:
Leadership	Clear Strength	Capable and Effective Performance	Could benefit from Development	Needs Significant Improvement	N/A, cannot comment
Can influence and persuade others to a course of action (Click here to add a comment)
Actively listens to employees as they explain their understanding of problems and situations (Click here to add a comment)
Expresses clear goals and objectives (Click here to add a comment)
Provides resources to enable individuals to develop professionally (Click here to add a comment)
Meets regularly with subordinates to align their work with the goals and objectives of the Company (Click here to add a comment)
Comment:
Teamwork	Clear Strength	Capable and Effective Performance	Could benefit from Development	Needs Significant Improvement	N/A, cannot comment
Encourages collaboration of fellow employees to achieve results (Click here to add a comment)
Creates a climate that encourages team participation (Click here to add a comment)
Seeks and listens to other's contributions (Click here to add a comment)
Comes across as a reliable, committed team member (Click here to add a comment)
Actively participates as a team member (Click here to add a comment)
Comment:
Accountability	Clear Strength	Capable and Effective Performance	Could benefit from Development	Needs Significant Improvement	N/A, cannot comment
Is someone who is there when you need them (Click here to add a comment)
Creates a consistent process for prioritizing work (Click here to add a comment)
Able to effectively limit risk-taking while maintaining optimal performance (Click here to add a comment)
Accepts accountability for their results (Click here to add a comment)
Holds team accountable to meeting goals (Click here to add a comment)
Comment:





Attitude	Clear Strength	Capable and Effective Performance	Could benefit from Development	Needs Significant Improvement	N/A, cannot comment
Treats others with respect (Click here to add a comment)
Approachable and easy to talk to (Click here to add a comment)
Shows by their actions that they trust in the positive intentions of others (Click here to add a comment)
Has a concern for employees in the department (Click here to add a comment)
Responds well to instructions and assignments (Click here to add a comment)
Comment:
Problem Solving	Clear Strength	Capable and Effective Performance	Could benefit from Development	Needs Significant Improvement	N/A, cannot comment
Able to solve problems at root cause rather than at symptom level (Click here to add a comment)
Able to develop innovative solutions to problems (Click here to add a comment)
Develops creative solutions (Click here to add a comment)
Asks the right questions to size up or evaluate situations (Click here to add a comment)
Links process improvement and results improvement (Click here to add a comment)
Comment:
Decision Making	Clear Strength	Capable and Effective Performance	Could benefit from Development	Needs Significant Improvement	N/A, cannot comment
Balances analysis with decisiveness in order to meet deadlines (Click here to add a comment)
Effectively chooses appropriate courses of action (Click here to add a comment)
Examines relevant factors needed to make a decision (Click here to add a comment)
Aware of his/her own skills and abilities (Click here to add a comment)
Asks for additional information when making critical decisions, rather than operate blindly (Click here to add a comment)
Comment:
Interpersonal Skills	Clear Strength	Capable and Effective Performance	Could benefit from Development	Needs Significant Improvement	N/A, cannot comment
Understands that stress is part of work and does not let it affect them personally (Click here to add a comment)
Demonstrates awareness of how specific actions, or inaction, could affect others (Click here to add a comment)
Gives honest feedback and suggestions for improvement (Click here to add a comment)
Is open to input on alternative ways to accomplish objectives (Click here to add a comment)
Facilitates the resolution of conflicts and grievances (Click here to add a comment)
Comment:





Comments

In the spaces provided below, please type in any comments/feedback about yourself that you believe are relevant to your development.

Describe the greatest strengths of this person with regard to his/her overall effectiveness in performing his/her current responsibilities.



Describe the most important things this person could improve upon in order to increase his/her overall effectiveness in performing his/her current responsibilities.



Any Other Comments:



---

Status of the Form

Upon clicking this button any responses will be saved. You can still return to the form to enter/review responses.



Upon clicking this button you are indicating that you have completed this questionnaire form.