Coworker Development - 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.

Co-worker Development

• Takes immediate action on poor performance
• Sets and clearly communicates expectations, performance goals, and measurements to others
• Works to identify root causes of performance problems
• Gives others development opportunities through project assignments and increased job responsibilities
• Provides ongoing feedback to co-workers on their development progress

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

Comments:

Emotional Intelligence

• Is attentive to emotional cues and interprets others' feelings correctly.
• Accurately perceives the emotional reactions of others.
• Is able to manage their own emotions.
• Is able to express themselves clearly.
• Helps employees to resolve conflicts, communicate clearly, and work together to solve problems.

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

Comments:

Quality

• Encourages employees to produce the best quality products.
• Corrects issues in a timely manner.
• Holds employees accountable for their quality of work.
• Encourages others to achieve high quality standards.
• Reflects on what is working and what could be improved.

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

Comments:

Achievement

• Sets challenging goals.
• Works at a quick pace to complete a high volume of work.
• Eliminates bureaucratic barriers to streamline processes.
• Strives to exceed standards of performance.
• Establishes Specific Measurable Achievable Realistic and Timed (SMART) goals.

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

Comments:

Trustworthy

• Seeks to mitigate grievances by clarifying intentions and finding suitable remedies.
• Demonstrates congruence between statements and actions.
• Takes care to maintain confidential information.
• Builds and maintains the trust of others.
• Takes ownership, delivers on commitments

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.