Change Management - 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.

Edit this Survey

Would you like to edit this survey? Click here to begin.

Change Management

• Effective in implementing new organizational vision and values.
• Inspires others to want to change.
• Effective in dealing with ambiguous and challenging situations.
• Able to get department employees to accept new changes.
• Develops plans for following through on the changes.

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

Comments:

Establishing Focus/Direction

• Excellent at managing time.
• Sets appropriate goals for employees.
• Stays focused even when under pressure and stress.
• Maintains self-control when personally criticized.
• Makes sure that employees understand and identify with the team's mission.

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

Comments:

Objectives

• Works toward achieving established goals and objectives.
• Organizes and schedules events, activities, and resources.
• Encourages me to take on greater responsibility.
• Establishes goals and objectives.
• Communicates goals and objectives to employees.

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

Comments:

Accountability

• Informs supervisor of progress without having to be asked about it.
• Works hard to ensure the success of the department.
• Exhibits a sense of ownership of the process.
• Able to complete required tasks on time and delivered expected results.
• Reviews performance to determine areas for improvement.

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

Comments:

Interpersonal Skills

• Is someone you can trust.
• Is open and approachable
• Provides constructive feedback in a way that fosters acceptance and development.
• Comes across as credible, knowledgeable and sincere
• Demonstrates compassion and understanding of 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.