Continual Learning - 360 Degree Feedback Survey Sample #5

360-Degree Assessment Survey

Dear Employee:

Thank you for participating in a 360-degree feedback assessment. In this process, you will complete a self-assessment questionnaire (below). You will also receive feedback from others including your manager, peers and direct reports. As you respond, please respond using just your experiences in the past 12 months. Rate each item using the scale shown. Comments can be very helpful; at a minimum where you give a particularly high or low rating, please share your reasons in the Closing Comments section. Your responses will be compiled with feedback from others and presented to you at the conclusion of this assessment to help guide your ongoing professional 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.

Please ensure that your submission is made by .

Thank you for your participation in the survey.

Management Team

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Continual Learning	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You take charge of your training and skills enhancement.
You set relevant learning objectives and goals.
You take the initiative to learn new skills.
You pursue learning that will enhance job performance.
You pursue professional development opportunities when they arise.
Self Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You step away from a situation to process appropriate response.
You do not allow own emotions to interfere with the performance of others.
You deal with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
You analyze interpersonal problems instead of reacting to them.
You use patience and self-control in working with customers and associates.
Professional Development	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You quickly acquire and apply new knowledge and skills when needed
You keep yourself up-to-date of technical/professional issues
You demonstrate enthusiasm and a willingness to learn new skills and knowledge
You allow employees to fully participate in employee training and professional development.
You are contributing fully to the extent of your skills
Punctuality	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You avoid making personal phone calls during working hours.
You arrive to meetings on time.
You invoice clients on a timely basis.
You start meetings on time.
You maintain an efficient schedule of activities.
Client Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You use client feedback to help improve products and services.
You create high quality products for the clients.
You document client interactions.
I ensure that commitments made to clients are completed to the client's satisfaction.
I am responsive to client needs.
Empowering Others	Role Model	Capable and Effective	Somewhat Effective	Needs Development
I recognize the expertise that employees have in certain areas and allow them the freedom to operate as they see fit.
You give employees the opportunity to make their own decisions at work.
I allow employees the freedom to do tasks how they see fit, but hold them accountable for obtaining results.
You give employees input into the decision making process.
I encourage independent, original thinking and creative problem-solving.
Recognition	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You offer recognition in a timely manner.
You are sincerely interested in the suggestions of co-workers
You let employees know when they have done well
You recognize individuals for a specific outstanding achievement.
You readily share credit and gives others opportunity for visibility.

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

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

    
    
37. Strengths
    
    
    
38. Areas for Development
    
    
    
39. Please give any final comments or suggestions for [Participant Name Here]'s assessment.