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

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

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

Comments:

Feedback

• Shares past experiences with others as learning opportunities.
• Actively seeks feedback from others.
• Is easy to approach with ideas and opinions.
• Considers other's opinion and suggestions.
• Looks to others for input.

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

Comments:

Leadership

• Able to influence others.
• Clearly explains performance expectations and goals to be reached at the beginning of a project, then let's others decide how to achieve the goal.
• Takes ownership and accountability for results
• Effectively leads others.
• Acts decisively in implementing decisions.

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

Comments:

Quality

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

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

Comments:

Strategic Insight

• Identifies root causes of problems.
• Analyzes records and reports to obtain insight into potential issues and trends.
• Communicates vision for the department and company.
• Anticipates business cycles and trends and makes adjustments in a timely manner.
• Analyzes unique issues or problems impacting 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.