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

• Sets appropriate goals for employees.
• Makes sure that employees understand and identify with the team's mission.
• Aligns the department's goals with the goals of the organization.
• Functions well under stress, deadlines, and/or significant workloads.
• Maintains self-control when personally criticized.

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

Comments:

Self Management

• Sets an example for associates during stressful periods by maintaining a positive, can-do attitude.
• Does not allow own emotions to interfere with the performance of others.
• Deals with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
• Uses patience and self-control in working with customers and associates.
• Is aware of personal impact on others and adjusts behavior to create a positive leadership presence.

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

Comments:

Results Oriented

• Works toward achievement of goals even when confronted with obstacles.
• Produces a high volume of work.
• Strives to achieve high volume of output.
• Has a strong result orientation.
• Determines what resources will be needed to achieve the objectives.

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

Comments:

Interpersonal Skills

• Is a role model for others demonstrating the importance of interpersonal skills.
• A good listener who is attentive to others.
• Creates diverse teams of individuals with different backgrounds, skills, and abilities.
• Values the opinions of others.
• Assists those in the department who need help in meeting performance metrics.

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

Comments:

Responsible

• Sets a good example
• Acts as a resource without removing individual responsibility.
• Responsible for setting the vision of the department.
• Holds herself / himself accountable to goals / objectives
• Sets a good example.

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.