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.

Action

• Makes decisions confidently and stands by them.
• Is proactive in addressing the needs of the department.
• Works at a quick pace.
• Takes corrective action when necessary.
• 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

• Contributing fully to the extent of their skills
• Seeks opportunities for continuous learning.
• Allows employees to fully participate in employee training and professional development.
• Keep themselves up-to-date of technical/professional issues
• Seeks opportunities for professional development.

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

Comments:

Decision Making

• Has a good rapport other people which is helpful in making decisions on the team.
• Applies creative reasoning in making decisions.
• Decides which short- and long-term goals should be created.
• Examines for patterns in data to help predict future possibilities.
• Understands how different perspectives can help make better informed decisions.

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

Comments:

Interpersonal Skills

• Values the input from coworkers.
• Provides constructive feedback in a way that fosters acceptance and development.
• Offers praise to colleagues who have successfully completed major projects.
• Assists employees that need help.
• Is well respected in the department.

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

Comments:

Others

• Able to see issues from others' perspectives.
• Respects the opinions of other employees.
• Includes others in the decision making processes.
• Forms working relationships with employees from other departments.
• Consistently demonstrates ability and willingness to trust others.

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.