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

• Works cooperatively with others to implement changes.
• Adopts changes to set and example for others to follow.
• Inspires others to want to change.
• Develops plans for following through on the changes.
• Inspires others to accept changes.

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

Comments:

Establishing Focus/Direction

• Stays focused even when under pressure and stress.
• Sets appropriate goals for employees.
• Maintains focus when handling several problems or tasks simultaneously.
• Excellent at managing time.
• Maintains self-control when personally criticized.

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

Comments:

Objectives

• Establishes goals and objectives.
• Communicates goals and objectives to employees.
• Organizes and schedules events, activities, and resources.
• Assures [Company] principles are understood, employed & pursued.
• Consistently provides me with timely feedback for improving my performance.

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

Comments:

Accountability

• Is someone you can trust.
• Defines roles, rights, and responsibilities of the team.
• Tackles issues head on and finds solutions.
• Takes responsibility for results.
• Holds team accountable to meeting goals.

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

Comments:

Interpersonal Skills

• Anticipates the concerns of other employees.
• Is trusted by peers and co-workers; others are willing to confide in him/her
• Effectively manages conflicts by dealing with them directly and immediately
• Values the opinions of others.
• Applies appropriate communication techniques to the situation.

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.