Empowering Others - 360 Degree Feedback Survey Sample #12

360 Feedback Survey

Instructions

We appreciate you taking the time to provide valuable feedback for the individual mentioned above. As you respond, please draw on your first-hand experience with this individual in the past 12 months. Your insights are crucial in offering a comprehensive evaluation. Please rate each item using the scale provided. If you find that you do not have sufficient first-hand knowledge to rate a particular item, select the Not Applicable option.

In addition to the ratings, we encourage you to include comments where possible. These comments are particularly useful when you give a very high or very low rating, as they provide context and clarity regarding your assessment. Explaining your reasons in the comment section helps ensure that your feedback is constructive and actionable.

Your responses, combined with feedback from other contributors, will be compiled and presented to the individual. This collective feedback aims to support their continuous growth and development by highlighting strengths and identifying areas for improvement. Your thoughtful participation is essential in helping them achieve their full potential.

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.

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Empowering Others

• Values the expertise that others bring to the team.
• Values the opinions of others.
• Is confident in the abilities of employees assigned important tasks.
• Expresses confidence in the abilities of others.
• Gives employees the freedom to set their own schedule.

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

Comments:

Decision Making

• Effectively chooses appropriate courses of action.
• Performs a cost/benefit analysis before making a decision.
• Uses reasonable assumptions and logic to decide between alternate courses of action
• Views the long and short-term impact of decisions.
• Regularly evaluates information before making important decisions.

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

Comments:

Juggling Multiple Responsibilities

• Can multitask while performing all of their other responsibilities and activities.
• Ranks the importance of tasks to make sure critical tasks are completed first.
• Switches attention to more urgent tasks when necessary.
• Assesses current capabilities before committing to new requests from customers.
• Integrates developing others with driving sales, serving customers, merchandising, performing operational procedures, and maintaining an appealing store environment.

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

Comments:

Organizational Fluency

• Anticipates problems that may affect the department.
• Adept at navigating within the culture of the department.
• Gets things done through the department.
• Understands departmental policies and procedures.
• Effective in communicating with others within the organization.

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

Comments:

Cultural Awareness

• Effective in working with individuals with a variety of cultural backgrounds.
• Hires individuals with different cultural backgrounds for the department.
• Accepts individual differences.
• May advocate for others with different cultural backgrounds.
• Values the diverse perspectives from others.

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.