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

• Helps guide employees with prioritizing tasks.
• Excellent at managing time.
• Makes sure that employees understand how their work relates to organizational goals.
• Sets appropriate goals for employees.
• Makes sure that employees understand and identify with the team's mission.

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

Comments:

Self Management

• Analyzes interpersonal problems instead of reacting to them.
• Is aware of personal impact on others and adjusts behavior to create a positive leadership presence.
• 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.
• 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

• Concentrates efforts on the most urgent needs.
• Completed work exceeds standards.
• Completes all assigned tasks.
• Removes bureaucratic barriers to streamline processes.
• Plans the best course of action to achieve the goal.

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

Comments:

Interpersonal Skills

• Values the input from coworkers.
• Works diligently to assist customers in finding the right products.
• Is willing to lend a hand to those in the department who need help.
• Demonstrates good communication with colleagues and customers.
• Is well respected in the department.

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

Comments:

Responsible

• Sets a good example.
• Holds herself / himself accountable to goals / objectives
• Is a person you can trust.
• Completes assigned work tasks.
• Works in a way that makes others want to work with her/him.

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.