Client Focus - 360 Degree Feedback Survey Sample #6

360-Degree Assessment Survey

Dear Employee:

You have been selected to participate in a 360-assessment. As part of this process you will need to complete the self-assessment questionnaire below.

In responding to the questions below, think about your experiences over the last 12 months. The effectiveness of this development tool is dependent on your honest, forthright and constructive responses so please bear this in mind as you answer each question. Your responses will be aggregated with the responses received from others. A report will be shared with you at the conclusion of this project.

We encourage everyone to complete the survey. Please be honest, constructive and thoughtful in your input. The survey is designed to help us understand more about your thoughts and needs to make this a great company.

The results of this survey will be used to help drive our future success. We will report back to you about what you have said and what we plan to do about it. If you have any questions about the process please contact [Contact Person].

Please ensure that your submission is made between . The survey will only be available during these dates.

Thank you for your participation in the survey. We look forward to seeing the analysis of your responses and we are hoping for 100% participation.

Management Team

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Client Focus	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I promptly respond to clients.
You create customized solutions for the client.
I deliver customized solutions for each client.
I act with integrity in all client interactions.
I am consistent in services provided to clients.
Creativity	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I tailor creative solutions to deliver meaningful outcomes for users, clients, or patients.
You find creative ways to meet the needs of patients.
I create opportunities for self-directed creative inquiry.
I pursue continuous learning as a foundation for generating creative outcomes.
I reflect on past outcomes to inform more creative future decisions.
Passion To Learn	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You take advantage of training opportunities when they arise.
You are open to feedback from others.
You exhibit willingness to upgrade skills through additional training and education.
You constantly enhance product knowledge through experimentation and play.
You stay up-to-date on emerging technologies.
Co-worker Development	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You adapt coaching and mentoring approach to meet the style or needs of individuals
You set and clearly communicate expectations, performance goals, and measurements to others
You work to identify root causes of performance problems
You take immediate action on poor performance
You provide ongoing feedback to co-workers on your development progress
Technology Use/Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You use technology in decision making and problem solving.
You adopt the implementation of new technology into the workplace.
You support technical training and development of employees.
You support employee training and development initiatives regarding implementation of technology.
You are proficient in the use of technical systems and processes.
Collaboration	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I foster strong collaborative relationships with suppliers.
I actively seek opportunities to work with colleagues to address and resolve challenges.
I share knowledge, ideas and resources to achieve quicker success.
You listen and attend to the ideas from others.
I foster a collaborative work environment where mutual inspiration leads to innovative problem-solving.
Strategic Focus	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I maintain a strategic focus on external factors impacting the success of the company.
I am effective in using strategic tools such as value chain analysis, business environment analysis, and competitor analysis.
I maintain a strategic focus to sustain competitiveness in changing business environments.
You look for opportunities to enhance contributions to the bottom line.
I strategically focus efforts to improve operational efficiencies.
Planning	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You anticipate resources needed to successfully implement a plan or project.
I prioritize plans based on a cost/benefit analysis.
I can develop a strategic plan to reduce costs in the department.
I can accurately estimate the amount of materials/supplies needed for the project.
I am able to efficiently manage deadlines.

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

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

    
    
42. Describe the greatest strengths of this person with regard to his/her overall effectiveness in performing his/her current responsibilities.
    
    
    
43. Describe the most important things this person could improve upon in order to increase his/her overall effectiveness in performing his/her current responsibilities.
    
    
    
44. Additional comments, if any for [Participant Name Here]'s assessment.