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Example 360 Feedback 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.

    Situational Awareness

    		 Needs
    Improvement    		 Could Benefit
    from
    Development    		 Excels;
    Above
    Average    		 Is a
    Role Model
    for Others    		 Don't
    Know
    1. Accepts the views of others.
    1. Actively seeks feedback from others.
    1. Asks others for their ideas and opinions.
    1. Is easy to approach with ideas and opinions
    1. Looks to others for input
    1. Seeks and utilizes data from several sources.
    1. Seeks feedback to enhance performance.
    Do you have any additional comments about this individual's job performance for this area? If so, please explain.

    Accountability

    		 Needs
    Improvement    		 Could Benefit
    from
    Development    		 Excels;
    Above
    Average    		 Is a
    Role Model
    for Others    		 Don't
    Know
    1. Acts like an owner when they make decisions.
    1. Can be counted on to do what they say they are going to do.
    1. Defines roles, rights, and responsibilities of employees
    1. Tackles issues head on and finds solutions.
    1. Takes responsibility for results.
    1. Takes ownership of mistakes and learns from them.
    1. Is someone you can trust.
    1. Is someone who is there when you need them.
    1. Encourages employees to take on greater responsibilities
    1. Informs supervisor of progress without having to be asked about it
    Do you have any additional comments about this individual's job performance for this area? If so, please explain.

    Teamwork

    		 Needs
    Improvement    		 Could Benefit
    from
    Development    		 Excels;
    Above
    Average    		 Is a
    Role Model
    for Others    		 Don't
    Know
    1. Creates a culture that fosters and values collaboration
    1. Partners with people from other work units to improve overall performance
    1. Creates and implements team reward and recognition programs
    1. Contributes to and supports team decision-making process
    1. Promotes open participation and communication within department and throughout the organization.
    1. Fosters teamwork rather than individual competition
    1. Open to the suggestions of others when working on a problem?
    1. Ensures that the right people are on the team in the appropriate roles.
    1. Helps other managers in need of assistance, such as providing needed resources (co-workers, supplies, etc.)
    1. Facilitates conflict resolution discussions between individuals in different teams
    Do you have any additional comments about this individual's job performance for this area? If so, please explain.

    Communication Skills

    		 Needs
    Improvement    		 Could Benefit
    from
    Development    		 Excels;
    Above
    Average    		 Is a
    Role Model
    for Others    		 Don't
    Know
    1. Accurately attends to/understands ideas which are exchanged.
    1. Communicates effectively to all levels of the organization.
    1. Conducts regular performance feedback discussions with individuals and teams
    1. Reviews any "action steps" resulting from meetings or conversations before concluding to ensure clarity and that plans will be executed
    1. An effective listener who is responsive to information needs
    1. Presents issues, ideas, and strategy concisely and clearly.
    1. Delivers difficult messages to co-workers in an appropriate manner
    1. Conveys ideas confidently and succinctly.
    1. Conveys priorities with right sense of urgency and importance.
    1. Takes time to listen to you
    1. Communicates the vision of the organization to all employees
    1. Listens actively & speaks clearly and directly.
    Do you have any additional comments about this individual's job performance for this area? If so, please explain.

    Leadership

    		 Needs
    Improvement    		 Could Benefit
    from
    Development    		 Excels;
    Above
    Average    		 Is a
    Role Model
    for Others    		 Don't
    Know
    1. Maximizes the efforts of all team members
    1. Uses persuasion and influence instead of micromanaging employees
    1. Acts decisively in implementing decisions
    1. Critiques own performance as a means of self-improvement and initiates self-development activities
    1. Demonstrates empathy for the impact of change on people and processes
    1. Empowers others to achieve results and holds them accountable for actions.
    1. Implements decision and evaluates results.
    1. Motivates others to reach and exceed organizational goals and objectives.
    1. Performs effectively, even under frustrating or challenging work conditions
    1. Supports Company sponsored training and development initiatives.
    1. Takes ownership and accountability for results
    Do you have any additional comments about this individual's job performance for this area? If so, please explain.

    Problem Solving

    		 Needs
    Improvement    		 Could Benefit
    from
    Development    		 Excels;
    Above
    Average    		 Is a
    Role Model
    for Others    		 Don't
    Know
    1. Looks for opportunities to enhance contributions to the bottom line?
    1. Makes judgments based upon relevant information.
    1. Analyzes alternatives and selects a course of action.
    1. Able to develop innovative solutions to problems
    1. Collects relevant information and data.
    1. Ability to solve problems at root cause rather than at symptom level
    1. Identifies fresh approaches and shows a willingness to question traditional assumptions.
    1. Analyzes systems and processes for opportunities to gain efficiency.
    1. Assumes new and difficult challenges and manages them as opportunities.
    1. Implements solutions and evaluates results.
    Do you have any additional comments about this individual's job performance for this area? If so, please explain.




    Open-Ended Comments

    Note: When you enter text comments into the boxes below, please focus your comments on work behaviors and styles. The comments that you type will be viewed by the individual receiving the feedback. Do not enter personal information about yourself unless you want this individual to know you are the author of these comments.



    Strengths:


    Opportunities for Development:

    Status of the Form

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

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