Action - 360 Degree Feedback Survey Sample #9

360 Feedback Survey

Self-Assessment Instructions

Thank you for agreeing to participate in this leadership training process. As part of this process, you will be completing the self-assessment questionnaire (below). As you respond, please draw on your work experiences over the past 12 months. Rate each item using the scale shown. Comments at the end can help you to explain your ratings. If you gave a particularly high or low rating, please share your reasons in the comment section for that competency. Your responses will be compiled with feedback from others and presented to you at the next leadership seminar to help guide your ongoing professional development.

You can save your progress on partially completed forms by clicking the Save/Still Working button located at the bottom of the page. This allows you to come back at a later time to finish or make any necessary edits to the form. When you return, your previously saved responses will automatically be displayed, allowing you to seamlessly continue where you left off. When you have completed filling out the form and are confident that no further changes are needed, please click the Complete button.

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Action	Definite Strength	Meets Standards	Needs Development	N/A
You anticipate critical incidents in the department and take steps to mitigate their effect.
I take advantage of changes to the current situation.
I am proactive rather than reactive in work.
I am proactive in addressing the needs of the department.
I encourage and support a culture of excellence and continuous improvement within the department.
Performance	Definite Strength	Meets Standards	Needs Development	N/A
You set a high standard for job performance.
You work well in this position.
You shown significant improvement in job performance.
You listen and respond to issues and problems
You are able to organize work.
Flexibility	Definite Strength	Meets Standards	Needs Development	N/A
I effectively manage changes in financial resources.
I respond to changing governmental regulations.
I encourage open communication and collaboration, allowing everyone to contribute their ideas and perspectives.
You scale up production capabilities in response to growing service demands.
You are effective in incorporating new ideas.
Emotional Intelligence	Definite Strength	Meets Standards	Needs Development	N/A
You are able to control your own emotions.
You are able to understand others' points of view.
You are able to express yourself clearly.
You help employees to resolve conflicts, communicate clearly, and work together to solve problems.
You are able to manage your own emotions.
Communication Skills	Definite Strength	Meets Standards	Needs Development	N/A
I articulate ideas clearly and assertively.
I use polite language and show respect for others' opinions and time.
I transform complicated ideas into simple ones.
You address issues of key importance to stakeholders.
I am willing to accept feedback from others.
Persuasion and Influence	Definite Strength	Meets Standards	Needs Development	N/A
I am viewed by others as someone with credibility and authority.
You take a long-term view and acts as a catalyst and champion of change.
I perform a situational analysis to determine the appropriate way to implement the project.
You align proposals with factual trends or performance benchmarks to underscore relevance and urgency.
You describe the issue in terms of the customer's experience to help create a mental image for employees to connect emotionally to issues facing customers.
Goals	Definite Strength	Meets Standards	Needs Development	N/A
You serve as a committed partner to significantly enhance the probability of achieving objectives.
You perform a risk assessment to identify potential obstacles which may change the priority of certain goals.
You encourage and assist employees in achieving their goals.
I understand the unique strengths and needs of each individual to create an environment that optimizes the achievement of shared goals.
You determine what needs to be achieved.
Technology Use/Management	Definite Strength	Meets Standards	Needs Development	N/A
You support technical training and development of employees.
You support employee training and development initiatives regarding implementation of technology.
You apply complex rules and regulations to maintain optimal system performance.
You are proficient in the use of technical systems and processes.
You identify gaps between actual and needed technical competencies and provide recommendations for required training.
Partnering/Networking	Definite Strength	Meets Standards	Needs Development	N/A
You effectively develop networks with colleagues that have shared interests.
I invest in other companies to form equity partnerships.
You build trust with colleagues at other companies to form partnerships to promote growth.
You utilize partners' key strengths to create mutual advantages.
You establish collaborative business relationships to unlock and enhance growth opportunities.
Teamwork	Definite Strength	Meets Standards	Needs Development	N/A
I am able to work closely other team members who are considered to be difficult to work with.
I help the team exercise good judgment by making sound and informed decisions.
You let team members know when they have done well.
I facilitate good rapport between team members.
You emphasize the importance of getting individuals to work as a team

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

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

    
    
52. Strengths
    
    
    
53. Areas for Development
    
    
    
54. Please give any final comments or suggestions for [Participant Name Here]'s assessment.