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

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

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

Comments:

Feedback

• Is visible and approachable.
• Actively seeks feedback from others.
• Considers other's opinion and suggestions.
• Asks others for their ideas and opinions.
• Accepts the views of others.

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

Comments:

Leadership

• Sets specific, measurable, and challenging goals.
• Sets clear goals and objectives for subordinates.
• Gives inspiring presentations or discussions.
• Sets a high level of performance expectations and challenges others to do the same.
• Recognizes individual and team accomplishments and reward them appropriately.

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

Comments:

Quality

• Always strives to produce the highest quality work products.
• Corrects issues in a timely manner.
• Encourages others to achieve high quality standards.
• Analyze what occurred and re-adjusts accordingly when goals are not met.
• Encourages others to produce the highest quality work products.

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

Comments:

Strategic Insight

• Formulates policies and strategies for addressing the Company's important challenges.
• Implements long-term solutions to problems.
• Formulates strategies and action plans to ensure successful completion of goals and objectives.
• Identifies potential problems before they become critical incidents.
• Creates strategies that significantly benefit the Company.

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.