Change Management - 360 Degree Feedback Survey Sample #12

360 Feedback Survey

Instructions

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 comment section for that competency. 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.

To what extent does [Participant Name] exhibit the following ...

SELECT the rating that best reflects the employee's performance in the areas listed.

Change Management

• Develops plans for following through on the changes.
• Adopts changes to set and example for others to follow.
• Supports the Company's efforts to implement changes.
• Facilitates change with minimal resistance.
• Able to get department employees to accept new 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.
• Maintains self-control when personally criticized.
• Helps guide employees with prioritizing tasks.
• 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

• Ability to establish realistic goals.
• Effectively organizes resources and plans
• Organizes and schedules events, activities, and resources.
• Able to organize work.
• Encourages me to take on greater responsibility.

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

Comments:

Accountability

• Encourages employees to take on greater responsibilities.
• Willing to answer for their own actions and performance.
• Informs the supervisor if progress on the task has been delayed.
• Accepts accountability for their actions and results.
• Commits to leading the initiatives to solving critical issues.

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

Comments:

Interpersonal Skills

• Communicates initiatives in a clear and actionable manner to employees.
• Understands the core issues of conversations.
• Gives credit where credit is due.
• Takes time to recognize the efforts of others.
• Assists employees that need help.

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.