Collaboration- 360 Degree Feedback Survey Sample #10

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.

Collaboration

• Creates an environment that encourages information sharing.
• Defines shared goals with the committee members.
• Makes decisions with other members of the group.
• Is a trustworthy and credible partner.
• Builds consensus among team members.

If [Participant Name] were to make improvements in Collaboration, what are your suggestions for how he/she can improve this?

Feedback

• Open to the suggestions of others.
• Looks to others for input.
• Considers other's opinion and suggestions.
• Shares past experiences with others as learning opportunities.
• Asks others for their ideas and opinions.

If [Participant Name] were to make improvements in Feedback, what are your suggestions for how he/she can improve this?

Delegation

• Entrusts subordinates with important tasks.
• Delegates authority and responsibility to subordinates and holds them accountable for their actions.
• Encourages and empowers subordinates to use initiative in achieving goals and objectives.
• Defines goals and objectives for subordinates.
• Tells subordinates what to do, not how to do it.

If [Participant Name] were to make improvements in Delegation, what are your suggestions for how he/she can improve this?

Time Management

• Completes high-priority work within required timelines.
• Keeps and maintains a To-Do list.
• Leaves time in the schedule for unplanned contingencies.
• Does not become flustered by deadlines and timelines.
• Does not procrastinate.

If [Participant Name] were to make improvements in Time Management, what are your suggestions for how he/she can improve this?

Recognition

• Recognizes team members who offer a significant contribution to a project.
• Recognizes the abilities and skills of self and others
• Makes people around them feel appreciated and valued.
• Says "thank you" to show appreciation for work of others.
• Lets employees know when they have done well

If [Participant Name] were to make improvements in Recognition, what are your suggestions for how he/she can improve this?

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

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

Strengths


Areas for Development


Please give any final comments or suggestions for [Participant Name Here]'s assessment.