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Rater: [Your Name]
You are providing feedback to: [Participant Name]
Instructions
You have been asked to evaluate yourself as part of a 360-degree developmental evaluation process. Other employees will also provide you with feedback. In this manner, you will be provided with a comprehensive, multi-perspective view of your performance. The end goal is to provide you with feedback so as to allow you to improve your performance, resulting in improved team performance, and organizational effectiveness.
Please provide feedback using the form below. If you are not able to respond to an item, leave it blank and go on to the next item. You do not have to complete entire questionnaire in one sitting. To save your data, press the SUBMIT button at the bottom of the form. You can re-access the survey questionnaire later by clicking on the link provided to you in the email message you received. You are able to return to the survey and enter/edit data as often as needed during the data collection period (_____ th - _____th).
Client Focus
Strongly
DisagreeDisagree
No
OpinionAgree
Strongly
Agree
Of the statements or questions listed above, which item do you think needs the most improvement?
Improvement needed in number:
What is your suggestion on how to improve this?
Accountability
Strongly
DisagreeDisagree
No
OpinionAgree
Strongly
Agree
Of the statements or questions listed above, which item do you think needs the most improvement?
Improvement needed in number:
What is your suggestion on how to improve this?
Achievement
Strongly
DisagreeDisagree
No
OpinionAgree
Strongly
Agree
Of the statements or questions listed above, which item do you think needs the most improvement?
Improvement needed in number:
What is your suggestion on how to improve this?
Excellence
Strongly
DisagreeDisagree
No
OpinionAgree
Strongly
Agree
Of the statements or questions listed above, which item do you think needs the most improvement?
Improvement needed in number:
What is your suggestion on how to improve this?
Decision Making
Strongly
DisagreeDisagree
No
OpinionAgree
Strongly
Agree
Of the statements or questions listed above, which item do you think needs the most improvement?
Improvement needed in number:
What is your suggestion on how to improve this?
Teamwork
Strongly
DisagreeDisagree
No
OpinionAgree
Strongly
Agree
Of the statements or questions listed above, which item do you think needs the most improvement?
Improvement needed in number:
What is your suggestion on how to improve this?
Empowering Others
Strongly
DisagreeDisagree
No
OpinionAgree
Strongly
Agree
Of the statements or questions listed above, which item do you think needs the most improvement?
Improvement needed in number:
What is your suggestion on how to improve this?
Strategic Focus
Strongly
DisagreeDisagree
No
OpinionAgree
Strongly
Agree
Of the statements or questions listed above, which item do you think needs the most improvement?
Improvement needed in number:
What is your suggestion on how to improve this?
Leadership
Strongly
DisagreeDisagree
No
OpinionAgree
Strongly
Agree
Of the statements or questions listed above, which item do you think needs the most improvement?
Improvement needed in number:
What is your suggestion on how to improve this?
Developing Others
Strongly
DisagreeDisagree
No
OpinionAgree
Strongly
Agree
Of the statements or questions listed above, which item do you think needs the most improvement?
Improvement needed in number:
What is your suggestion on how to improve this?
Responsible
Strongly
DisagreeDisagree
No
OpinionAgree
Strongly
Agree
Of the statements or questions listed above, which item do you think needs the most improvement?
Improvement needed in number:
What is your suggestion on how to improve this?
Integrity
Strongly
DisagreeDisagree
No
OpinionAgree
Strongly
Agree
Of the statements or questions listed above, which item do you think needs the most improvement?
Improvement needed in number:
What is your suggestion on how to improve this?
Interpersonal Skills
Strongly
DisagreeDisagree
No
OpinionAgree
Strongly
Agree
Of the statements or questions listed above, which item do you think needs the most improvement?
Improvement needed in number:
What is your suggestion on how to improve this?
Cultural Awareness
Strongly
DisagreeDisagree
No
OpinionAgree
Strongly
Agree
Of the statements or questions listed above, which item do you think needs the most improvement?
Improvement needed in number:
What is your suggestion on how to improve this?
Continual Improvement
Strongly
DisagreeDisagree
No
OpinionAgree
Strongly
Agree
Of the statements or questions listed above, which item do you think needs the most improvement?
Improvement needed in number:
What is your suggestion on how to improve this?
Most significant strengths related to leadership?
Leadership-related areas that you most need to focus on developing?