Bias for Action - 360 Degree Feedback Survey Sample #5

360-Degree Assessment Survey

Dear Employee:

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 Closing Comments section. 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.

Please ensure that your submission is made by .

Thank you for your participation in the survey.

Management Team

Bias for Action	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Displays high energy and enthusiasm on consistent basis.
Conveys a sense of urgency about addressing problems and opportunities
Projects a "can-do" attitude when interfacing with peers, subordinates and customers(especially during difficult and challenging times).
Completes work on time
Encourages risk taking and experimentation to improve performance
Objectives	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Works toward achieving established goals and objectives.
Encourages me to take on greater responsibility.
Consistently provides me with timely feedback for improving my performance.
Ability to establish realistic goals.
Effectively organizes resources and plans
Client Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Is pro-active in dealing with clients and addressing their needs.
Forms strong client relationships
Ensures client commitments and requirements are met or exceeded
Maintains strong relationships with clients.
Satisfies client needs.
Recognition	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Compliments other people when they do good work
Offers recognition in a timely manner.
Recognizes individuals for a specific outstanding achievement.
Readily shares credit and gives others opportunity for visibility.
Recognizes the abilities and skills of self and others
Entrepreneurship	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Encourages risk taking for developing potential business opportunities.
Devotes a certain amount of time and effort to developing new business opportunities.
Finds unique ways to go around barriers to success.
Excellent at managing relationships with stakeholders.
Balances risks and rewards when making decisions.
Fiscal Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Develops budgets and plans for various programs and initiatives.
Monitors spending.
Ensures others follow the correct rules and regulations on fiscal matters.
Develops of the department's annual budget.
Provides budgeting and accounting support to the Company.

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

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

    
    
32. Strengths
    
    
    
33. Areas for Development
    
    
    
34. Please give any final comments or suggestions for [Participant Name Here]'s assessment.