Establishing Focus/Direction - 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.

Establishing Focus/Direction

• Stays focused even when under pressure and stress.
• Functions well under stress, deadlines, and/or significant workloads.
• Excellent at managing time.
• Helps guide employees with prioritizing tasks.
• Makes sure that employees understand how their work relates to organizational goals.

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

Comments:

Self Management

• Uses patience and self-control in working with customers and associates.
• Analyzes own reactions on the spot to ensure that communication does not appear to be driven by anger.
• Deals with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
• Is aware of personal impact on others and adjusts behavior to create a positive leadership presence.
• Steps away from a situation to process appropriate response.

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

Comments:

Results Oriented

• Encourages a high-energy, fun work environment and coaches others on how to do the same
• Helps others when free-time is available.
• Directs team in prioritizing daily work activities
• Stays focused on meeting the needs of customers.
• Provides clear expectations for employees.

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

Comments:

Interpersonal Skills

• Effectively manages conflicts by dealing with them directly and immediately
• Demonstrates willingness to work with others.
• Provides constructive feedback in a way that fosters acceptance and development.
• Uses knowledge and charisma rather than position, power, or coercion to influence others
• Is a role model for others

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

Comments:

Responsible

• Holds herself / himself accountable to goals / objectives
• Sets a good example.
• Behavior is ethical and honest.
• Sets a good example
• Sets high personal standards of performance.

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.