Creativity - 360 Degree Feedback Survey Sample #5

360-Degree Assessment Survey

Dear Employee:

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 Closing Comments section. 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.

Please ensure that your submission is made by .

Thank you for your participation in the survey.

Management Team

Edit this Survey

Would you like to edit this survey? Click here to begin.

Creativity	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Is creative.
Conceives, implements and evaluates ideas.
Creates a lot of new ideas.
Is creative and inspirational.
Develops solutions to challenging problems.
Bias for Action	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Completes a large volume of work.
Identifies ways to simplify work processes and reduce cycle times
Coach others to foster an environment which can adapt quickly and willingly to rapid change.
Seeks and utilizes opportunities for continuous learning and self-development.
Conveys a sense of urgency about addressing problems and opportunities
Cultural Awareness	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Accepts individual differences.
Maintains an inclusive work environment that maximizes the talents of others in achieving goals.
Seeks out different viewpoints and benefits from different perspectives.
Hires individuals with different cultural backgrounds for the department.
Willing to work with employees who have different cultural backgrounds.
Performance	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Listens and responds to issues and problems
Effectively organizes resources and plans
...Overall Performance
Has great overall performance
Effective in performing his/her job.
Results Oriented	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Inspires and motivates co-workers to be productive and energetic at work
Sets important goals for the department.
Gives extra effort to solve problems and get work done on time.
Is a high achiever.
Works hard despite obstacles that impede progress.
Interpersonal Skills	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Strives to lead by example to demonstrate the value of interpersonal relationships.
Creates an atmosphere that supports the open expression of ideas
Provides constructive feedback in a way that fosters acceptance and development.
Is trusted by peers and co-workers; others are willing to confide in him/her
Is a role model for others demonstrating the importance of interpersonal skills.
Empowering Others	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Ensures employees understand what is being assigned to them.
Supports the decisions of others.
Values the expertise that others bring to the team.
Trusts employees with important responsibilities.
Gives employees opportunities to demonstrate their skills.
Partnering/Networking	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Develops partnerships with other colleagues in the industry.
Forges mutually beneficial relationships between individuals with diverse backgrounds.
Uses informal networks to share information.
Identifies partnerships with overseas companies to expand market opportunities.
Facilitates cross-functional collaboration and information sharing between various stakeholders.
Recognition	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Compliments other people when they do good work
Finds opportunities to recognize others.
Recognizes the abilities and skills of self and others
Makes people around them feel appreciated and valued.
Recognizes team members who offer a significant contribution to a project.
Entrepreneurship	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Maintains a high level of energy to respond to demands of the job.
Devotes a certain amount of time and effort to developing new business opportunities.
Can work effectively in an environment of uncertainty.
Encourages risk taking for developing potential business opportunities.
Finds unique ways to go around barriers to success.

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

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

    
    
52. Strengths
    
    
    
53. Areas for Development
    
    
    
54. Please give any final comments or suggestions for [Participant Name Here]'s assessment.