Action - 360 Degree Feedback Survey Sample #12

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.

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.

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Action

• Sets high standards for themselves and others.
• Is the first to volunteer for assignments.
• Ensures timely completion of tasks.
• Takes proactive steps to address potential issues before they became a problem.
• Does whatever it takes (within reason) to get the job done.

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

Comments:

Professional Development

• Seeks opportunities for professional development.
• Quickly acquire and apply new knowledge and skills when needed
• Allows employees to fully participate in employee training and professional development.
• Seeks opportunities for continuous learning.
• Demonstrate enthusiasm and a willingness to learn new skills and knowledge

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

Comments:

Decision Making

• Is firm in their decision and not easily influenced by the whims of others.
• Makes good decisions for the department.
• Maintains focus on the "big picture" when making decisions.
• Has a good rapport other people which is helpful in making decisions on the team.
• Breaks complex issues into manageable parts and organizes them in a systematic way before making decisions

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

Comments:

Interpersonal Skills

• Respectful of the opinions and ideas of others.
• Demonstrates a high degree of ethics and integrity in the workplace.
• Able to work with individuals at all levels of the Company.
• Demonstrates willingness to work with others.
• Communicates well at all levels of the organization.

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

Comments:

Others

• ...treats others with respect and dignity.
• Supports the efforts of other employees in implementing solutions to problems.
• Works across boundaries within the organization.
• Constructively receives criticism and suggestions from others.
• Forms working relationships with employees 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.