Action - 360 Degree Feedback Survey Sample #12

360 Feedback Survey

Instructions

Thank you for providing feedback for the recipient above. As you respond, please draw on your first-hand experience with this individual in the past 12 months. Rate each item using the scale shown. If you don't feel you have enough first-hand information to rate a certain item, please choose the Not Applicable option. Comments can be very helpful; at a minimum where you give 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 the recipient to help guide their ongoing development.

Partially completed forms can be saved by using the Save/Still Working button at the bottom of the page. You may return at a later time to complete/edit the form. Your saved responses will be shown each time you re-visit the feedback form. When you are certain that you have completed your responses and will be not making any changes, click the Complete button.

To what extent does [Participant Name] exhibit the following ...

SELECT the rating that best reflects the employee's performance in the areas listed.

Action

• Makes effective decisions, even when under pressure.
• Drives and mobilizes others progress toward goals.
• Motivates & supports others to gain skills
• Gets the job done.
• Is not afraid to take corrective action when necessary.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Professional Development

• Seeks opportunities for continuous learning.
• Encourages employees to take courses relevant to their job.
• Seeks opportunities for professional development.
• Allows employees to fully participate in employee training and professional development.
• Keep themselves up-to-date of technical/professional issues

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Decision Making

• Breaks complex issues into manageable parts and organizes them in a systematic way before making decisions
• Is able to make decisions quickly.
• Exercises good judgment by making sound and informed decisions.
• Asks for additional information when making critical decisions.
• Does not lose sight of the big picture when making decisions

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Interpersonal Skills

• Adapts management style to meet the needs of the individual or situation.
• Is a role model for others
• Able to work with individuals at all levels of the Company.
• Values the opinions of others.
• Effectively manages conflicts by dealing with them directly and immediately

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Others

• Able to see issues from others' perspectives.
• Is able to see issues from others' perspectives.
• Supports the efforts of other employees in implementing solutions to problems.
• Treats others with respect and dignity.
• Works effectively with people from other departments.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Strengths


Areas for Development


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