360 Degree Feedback Form - Example 3

Rater: [Your Name]
You are providing feedback to: [Participant Name]

Instructions

You have been selected to provide feedback for the manager listed above. Your feedback is an important part of our company'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 twelve months. Your responses will be merged with other'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 appraisal process, leaders receive feedback from peers, subordinates, customers and supervisors. 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 individual's annual appraisal and development plan.

Performance Rating Guide: Role model. Results consistently exceed expectations. Makes significant contributions well beyond requirements. Outpaces the majority of peers. Capable and Effective. Results are fully and consistently on target. Makes a valuable contribution. Is fully competent. This level describes performance of the majority of employees. Average. Results are usually on target. Would benefit from development. Results are usually on target. May need occasional support. Still learning how to perform responsibilities independently. Needs significant development. Improvement clearly needed. Is inconsistent in performance and requires continual supervision and support. An action plan for improvement in this area needed.

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Vision	Needs significant development	Would benefit from development	Average	Capable and effective	Role model
Diagnoses issues and envisions solutions.
Develops and executes a strategic vision for the organization.
Develops a vision to empower employees to make more effective decisions.
Inspires individuals to achieve success by clearly communicating the organization's vision and motivating them to align their personal goals with this vision.
Avoids mixed messages by ensuring verbal and non-verbal cues reflect the same priorities.
Results Oriented	Needs significant development	Would benefit from development	Average	Capable and effective	Role model
Sets priorities for tasks to be completed.
Clarifies the "why" behind expectations to foster intrinsic motivation and commitment.
Works hard despite obstacles that impede progress.
Determines what resources will be needed to achieve the objectives.
Completed work exceeds standards.
Continual Learning	Needs significant development	Would benefit from development	Average	Capable and effective	Role model
Grasps new ideas, concepts, technical, or business knowledge.
Improves on their skill sets.
Takes the initiative to learn new skills.
Takes charge of their training and skills enhancement.
Pursues learning that will enhance job performance.
Developing Others	Needs significant development	Would benefit from development	Average	Capable and effective	Role model
Develops employees by offering and encouraging them to take on new or additional responsibilities.
Assigns tasks and responsibilities to develop skills of others.
Is open to receiving feedback.
Supports the successes of other employees.
Recognizes and celebrates accomplishments of others.
Teamwork	Needs significant development	Would benefit from development	Average	Capable and effective	Role model
Listens carefully to other team members.
Fosters an environment that promotes active listening on the team.
Coaches team on how to solve problems, plan, and meet organizational goals and objectives.
Coaches team members
Is open to new ideas that may change own goals for benefit of the team
Bias for Action	Needs significant development	Would benefit from development	Average	Capable and effective	Role model
Projects a can-do attitude that, within the department, is contagious.
Uses creativity, problem-solving skills, and available resources to overcome challenges and deliver results.
Moves beyond theoretical discussions into tangible, result-driven actions, fostering a culture of proactivity and continuous progress.
Uses creativity to solve problems, tackle obstacles and make progress.
Is someone who wants to do more work.
Customer Focus	Needs significant development	Would benefit from development	Average	Capable and effective	Role model
Is competent in handling customer cases.
Prepares contingency plans for potential service disruptions that could impact customer satisfaction.
Provides training to others on how to improve customer service.
Ensures customers' expectations are met or exceeded.
Encourages the team to proactively seek ways to improve the customer experience.
Business Acumen	Needs significant development	Would benefit from development	Average	Capable and effective	Role model
Works cooperatively with others to implement business changes.
Can effectively interpret and analyze data.
Gathers important information from customers to make sure our products are relevant and useful.
Seeks to better understand other areas of the company, including their operations, personnel, and output.
Facilitates others in the development and implementation of changes to business operations.

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.

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