360 Feedback Example Questionnaire

This is an example of an on-line 360 Questionnaire. This questionnaire can be used for employee feedback to gather input from peers, direct reports, and manager(s).

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.

    Interpersonal

    Clear Strength Capable and Effective Performance Could benefit from Development Needs Significant Improvement N/A,
    cannot comment
    1. Establishes good rapport with employees and customers.
    1. Treats others with respect.
    1. Defuses hostile/angry individuals in group settings to prevent disruption of work.
    1. Secures commitment from subordinates, supervisors, and members of other departments when working to gain support for ideas or decisions.
    1. Listens to and interacts with customers and team members in an effective, tactful, and pleasant way.
    1. Provides constructive feedback in a way that fosters acceptance and development.
    Comment:

    Leadership

    Clear Strength Capable and Effective Performance Could benefit from Development Needs Significant Improvement N/A,
    cannot comment
    1. Instills important values and vision within the department employees.
    1. Runs efficient and effective meetings with agendas, action items, and accountabilities clearly spelled out.
    1. Communicates calmly and honestly with co-workers, customers, and supervisors, even when stressed.
    1. Sets a high level of performance expectations and challenges others to do the same.
    1. Coaches core team to document and hold co-workers accountable for assignments and commitments.
    1. Encourages self-development for employees at all levels of the organization.
    1. Recognizes individual and team accomplishments and reward them appropriately.
    1. Fosters team cooperation, builds trust among team members and creates commitment to team goals.
    1. Provides individual coaching for employees as needed.
    Comment:

    Results Orientation/Leading Change

    Clear Strength Capable and Effective Performance Could benefit from Development Needs Significant Improvement N/A,
    cannot comment
    1. Effective in implementing new organizational vision and values.
    1. Supports new initiatives for organizational changes to improve effectiveness.
    1. Stays focused on solving problems and getting work done.
    1. Accomplishes difficult tasks obtaining measurable results.
    1. Measures performance against goals and objectives.
    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.
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