Excellence - 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.

Excellence

• Demonstrates the functional or technical skills necessary to do their job.
• Takes a lot of pride in their work.
• Can be counted on to add value wherever they are involved.
• Produces high quality work.
• Keeps themselves and others focused on constant improvement.

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

Comments:

Feedback

• Open to the suggestions of others.
• Is easy to approach with ideas and opinions.
• Seeks feedback to enhance performance.
• Shares past experiences with others as learning opportunities.
• Looks to others for input.

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

Comments:

Leadership

• Able to align manpower, design work, an allocate tasks to achieve goals.
• Highly effective supervisor.
• Sets a high level of performance expectations and challenges others to do the same.
• Recognizes individual and team accomplishments and reward them appropriately.
• Able to organize the work of others.

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

Comments:

Quality

• Encourages employees to produce the best quality products.
• Encourages others to produce the highest quality work products.
• Reflects on what is working and what could be improved.
• Analyze what occurred and re-adjusts accordingly when goals are not met.
• Encourages others to achieve high quality standards.

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

Comments:

Strategic Insight

• Inspires employees to adopt the strategic plan.
• Adjusts strategic plans based on insights gathered from different points of view.
• Creates a mission statement describing the purpose for the organization.
• Analyzes records and reports to obtain insight into potential issues and trends.
• Formulates policies and strategies for addressing the Company's important challenges.

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.