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HR-Survey > 360-Degree Feedback > Competency Model > Initiative

Initiative - 360 Degree Feedback Survey Sample #13

November 2, 2025

Instructions
Questionnaires Measuring Initiative:
You have been selected to provide valuable feedback for the Survey 1 (4-point scale; Competency Comments)
manager listed above. Your insights are an important part of Survey 2 (4-point scale; Competency Comments)
[Participant]'s leadership development process. This tool is designed Survey 3 (5-point scale; Competency Comments)
to gather broad and comprehensive feedback on the core Survey 4 (5-point scale; radio buttons)
competencies and role responsibilities that are crucial for the Survey 5 (4-point scale; words)
continuous success of our organization. Survey 6 (4-point scale; words)
Survey 7 (5-point scale; competency comments; N/A)
When responding to the assessment form, please consider your Survey 8 (3-point scale; Agree/Disagree words; N/A)
experiences working with this individual over the past six to twelve Survey 9 (3-point scale; Strength/Development; N/A)
months. Reflect on specific instances, interactions, and overall Survey 10 (Comment boxes only)
performance that you have observed. Your responses will be Survey 11 (Single rating per competency)
combined with feedback from other colleagues to create a holistic Survey 12 (Slide-bar scale)
view of the manager's strengths and areas for improvement. This Survey 13 (4-point scale; numbers; floating anchors)
collective feedback will be used to guide their ongoing professional Survey 14 (4-point scale; N/A)
development.

Please be candid and constructive in your comments, as they will be shared anonymously with the manager. Your feedback will be
instrumental in helping them understand their impact on the team and the organization, and in identifying opportunities for growth.
We appreciate your time and effort in contributing to this important process.

Method of use: As part of the review process, managers will receive

feedback from peers and staff. It is recognized that not all Sample Result Document:
participants will be able to assess an individual's performance in all Sample Results
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 Competencies Included:
actual behaviors to the scale provided. Initiative, Achievement, Bias for Action, Collaboration,
Fiscal Management, Passion To Learn, Attitude,
If you are not sure, or unable to assess, select "Not Applicable" Performance
(N/A) option.

Please complete your response by November 16.

Strongly Strongly
Initiative Disagree Disagree Agree Agree

1. Is proactive when preparing for potential problems

or critical events. 1 2 3 4

2. Takes action in the absence of specific direction. 1 2 3 4

3. Initiates draft reports for consideration. 1 2 3 4

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 4. Looks to start work on new projects without waiting
for direction from the manager. 1 2 3 4

5. Gladly seeks additional responsibilities. 1 2 3 4

6. Takes corrective action to rectify issues. 1 2 3 4

7. Is an inspiration for others to perform above

expectations. 1 2 3 4

8. Takes appropriate actions to address problems or

issues. 1 2 3 4

9. Begins immediate action on projects. 1 2 3 4

Strongly Strongly
Achievement Disagree Disagree Agree Agree

10. Champions process improvements that enhance

productivity, compliance, and overall success. 1 2 3 4

11. Is flexible in adjusting priorities to meet the

demands of changing situations. 1 2 3 4

12. Reduced department expenses by 25 percent. 1 2 3 4

13. Increased revenue for the company. 1 2 3 4

14. Moves decisively to complete initiatives ahead of

schedule. 1 2 3 4

Strongly Strongly
Bias for Action Disagree Disagree Agree Agree

15. Is accountable for the outcomes of decisions,

whether they lead to success or require adjustments. 1 2 3 4

16. Adapts to changing circumstances and finds new

ways to achieve goals. 1 2 3 4

17. Develops contingency plans for various scenarios,

ensuring the team is prepared for different 1 2 3 4
outcomes.

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 18. Prioritizes tasks effectively, often choosing tasks that
have the highest impact or urgency. 1 2 3 4

19. Maintains concentration and avoiding distractions

to ensure consistent progress. 1 2 3 4

Strongly Strongly
Collaboration Disagree Disagree Agree Agree

20. Keeps everyone aligned and motivated to maintain

a cohesive and productive team. 1 2 3 4

21. Effectively uses digital tools do you use to improve

collaboration in the department. 1 2 3 4

22. Involves others in reaching a consensus during

group activities. 1 2 3 4

23. Promotes a culture of collaboration, shared

inspiration and creativity to tackle workplace 1 2 3 4
problems.

24. Effectively works with others to create solutions to

problems. 1 2 3 4

Strongly Strongly
Fiscal Management Disagree Disagree Agree Agree

25. Develops of the department's annual budget. 1 2 3 4

26. Monitors expenses and verifies the need for items

purchased. 1 2 3 4

27. Ensures others follow the correct rules and

regulations on fiscal matters. 1 2 3 4

28. Keeps excellent records for financial transparency. 1 2 3 4

29. Monitors spending. 1 2 3 4

Strongly Strongly
Passion To Learn Disagree Disagree Agree Agree

30. Creates an environment that supports personal

development and exploration. 1 2 3 4
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 31. Stays up-to-date on emerging technologies. 1 2 3 4

32. Demonstrates a willingness to participate in

continuing education courses. 1 2 3 4

33. Enhances value to the company through additional

training and development. 1 2 3 4

34. Exhibits willingness to upgrade skills through

additional training and education. 1 2 3 4

Strongly Strongly
Attitude Disagree Disagree Agree Agree

35. Approaches failures as stepping stones toward

improvement. 1 2 3 4

36. Encourages team members of the potential benefits

of taking a bold step, even if success isn't 1 2 3 4
guaranteed.

37. Celebrates team achievements with genuine

enthusiasm, showcasing investment in collective 1 2 3 4
success.

38. Exhibits a professional and gracious demeanor. 1 2 3 4

39. Looks for ways to succeed in spite of any obstacles

or circumstances. 1 2 3 4

Strongly Strongly
Performance Disagree Disagree Agree Agree

40. Works well in this position. 1 2 3 4

41. Listens and responds to issues and problems 1 2 3 4

42. Able to organize work. 1 2 3 4

43. Effectively organizes resources and plans 1 2 3 4

44. Has great overall performance 1 2 3 4

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

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

47. Overall, please rate the effectiveness of [Participant Name Here].

5- Very Effective
4- Effective
3- Neither
2- Ineffective
1- Very Ineffective

48. Please give any final comments or suggestions for [Participant Name Here]'s assessment.

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