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

Continual Learning	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You share best practices with others and learn from others.
You seek opportunities to grow in skills and knowledge.
You are open to new ideas and concepts.
I view setbacks as opportunities to learn from.
You pursue self-improvement through continual learning.
Self Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You are aware of personal impact on others and adjusts behavior to create a positive leadership presence.
You consciously control own negative emotions in order to keep team morale up.
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 own reactions on the spot to ensure that communication does not appear to be driven by anger.
Professional Development	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You seek opportunities for professional development.
You encourage employees to take courses relevant to their job.
You keep yourself up-to-date of technical/professional issues
You are contributing fully to the extent of your skills
You quickly acquire and apply new knowledge and skills when needed
Punctuality	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You respond to requests for information in a timely manner.
You avoid making personal phone calls during working hours.
You conduct appointments at scheduled start time.
You start meetings on time.
You invoice clients on a timely basis.
Client Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You document client interactions.
You create high quality products for the clients.
You put client's needs first.
I identify the core needs of the client.
I create an environment that enables clients to receive excellent service.
Empowering Others	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You recognize that employees may need flexibility in their working hours.
I consider ideas from employees that may challenge traditional ways of doing the job.
I allow the team to take responsibility for the project.
You recognize the contributions that others make to the department.
You trust employees to complete tasks assigned.
Recognition	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You reinforce and reward employees for accomplishing necessary goals.
You recognize individuals for a specific outstanding achievement.
You offer recognition in a timely manner.
You readily share credit and gives others opportunity for visibility.
You recognize team members who offer a significant contribution to a project.

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.