Change Management - 360 Degree Feedback Survey Sample #5

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

Change Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Assists others in understanding changes to the organization.
Addresses organizational and departmental resistance to changes.
Supports the Company's efforts to implement changes.
Works cooperatively with others to implement changes.
Effective in dealing with ambiguous and challenging situations.
Achievement	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Completes work to given time frame and to budget
Demonstrates a well-organized and timely approach to achieve desired results
Set high standards in their performance
Completes work to a high technical standard
Makes a plan for getting things done and drives execution of the strategic plan, actively supporting or leading initiatives to closure.
Clarity	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Attends to the important details of a job or task.
Clarifies problems and their causes to help employees correct them.
Avoids stating unclear or conflicting goals.
Makes sure goals and objectives are clearly and thoroughly explained and understood.
Checks details thoroughly.
Managing Risk	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Able to adapt quickly to changing situations.
Bases decisions on patterns found in fluid/changing information.
Maintains open communication with other departments.
Rewards innovative experiments to try new ideas.
Recognizes that small changes may snowball into major events.
Trustworthy	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Consistently keeps commitments.
Is a person you can trust.
Delivers on promises made.
Seeks to mitigate grievances by clarifying intentions and finding suitable remedies.
Demonstrates a sense of responsibility and commitment to public trust.
Coaching	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Develops the skills and capabilities of others.
Coaches employees in how to strengthen knowledge and skills to improve work performance.
Addresses employee behavior problems effectively.
Provides clear, motivating, and constructive feedback.
Helps employees to maintain high personal standards.
Recognition	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Recognizes the abilities and skills of self and others
Compliments other people when they do good work
Offers recognition in a timely manner.
Makes people around them feel appreciated and valued.
Readily shares credit and gives others opportunity for visibility.
Business Acumen	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Understands complex issues and problems.
Exhibits behavior that is consistent with the vision, mission, and core values of the organization
Considers impact of actions on other areas of the organization.
Applies the knowledge of work processes to influence the achievement of business goals
Able to align resources to meet the business needs of the company.

41. Overall, please rate the effectiveness of .
    

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

    
    
42. Strengths
    
    
    
43. Areas for Development
    
    
    
44. Please give any final comments or suggestions for 's assessment.