Action - 360 Degree Feedback Survey Sample #10

360 Feedback Survey

Instructions

We appreciate you taking the time to provide valuable feedback for the individual mentioned above. As you respond, please draw on your first-hand experience with this individual in the past 12 months. Your insights are crucial in offering a comprehensive evaluation. Please rate each item using the scale provided. If you find that you do not have sufficient first-hand knowledge to rate a particular item, select the Not Applicable option.

In addition to the ratings, we encourage you to include comments where possible. These comments are particularly useful when you give a very high or very low rating, as they provide context and clarity regarding your assessment. Explaining your reasons in the comment section helps ensure that your feedback is constructive and actionable.

Your responses, combined with feedback from other contributors, will be compiled and presented to the individual. This collective feedback aims to support their continuous growth and development by highlighting strengths and identifying areas for improvement. Your thoughtful participation is essential in helping them achieve their full potential.

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.

Action

• Works at a quick pace.
• Rapidly adapts to changes in the situation.
• Will take action to address a problem rather than to wait to confer with others about the situation.
• Fixes problems when they occur.
• Makes effective decisions, even when under pressure.

If [Participant Name] were to make improvements in Action, what are your suggestions for how he/she can improve this?

Continual Learning

• Sets relevant learning objectives and goals.
• Pursues learning that will enhance job performance.
• Participates in regular training offered.
• Takes the initiative to learn new skills.
• Grasps new ideas, concepts, technical, or business knowledge.

If [Participant Name] were to make improvements in Continual Learning, what are your suggestions for how he/she can improve this?

Cultural Awareness

• Seeks knowledge and information about other cultures.
• Functions effectively within various cultural contexts.
• Treats others with dignity and respect.
• Understands how implicit biases can affect decisions, communication and productivity.
• Is open and honest in communications with individuals from other cultures.

If [Participant Name] were to make improvements in Cultural Awareness, what are your suggestions for how he/she can improve this?

Excellence

• Is planful and organized.
• Demonstrates the analytical skills to do their job.
• Produces high quality work.
• Demonstrates the functional or technical skills necessary to do their job.
• Can be counted on to add value wherever they are involved.

If [Participant Name] were to make improvements in Excellence, what are your suggestions for how he/she can improve this?

Trustworthy

• Works in a way that makes others want to work with her/him.
• Takes ownership, delivers on commitments
• Builds and maintains the trust of others.
• Seeks to mitigate grievances by clarifying intentions and finding suitable remedies.
• Takes care to maintain confidential information.

If [Participant Name] were to make improvements in Trustworthy, what are your suggestions for how he/she can improve this?

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

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

Strengths


Areas for Development


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