Feedback - 360 Degree Feedback Survey Sample #5

360-Degree Assessment Survey

Dear Employee:

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 Closing Comments section. Your responses will be compiled with feedback from others and presented to the recipient to help guide their ongoing development.

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Please ensure that your submission is made by .

Thank you for your participation in the survey.

Management Team

Feedback	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Open to the suggestions of others.
Shares past experiences with others as learning opportunities.
Looks to others for input.
Actively seeks feedback from others.
Accepts the views of others.
Attitude	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Shows by their actions that they trust in the positive intentions of others.
Builds open and trusting relationships.
Contributes to a positive and fun work environment.
Is gracious and professional in their interactions with others.
Visibly supports and encourages diversity in style and background.
Trustworthy	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Takes care to maintain confidential information.
Takes ownership, delivers on commitments
Demonstrates a sense of responsibility and commitment to public trust.
Seeks to mitigate grievances by clarifying intentions and finding suitable remedies.
Builds and maintains the trust of others.
Customer Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
...friendliness and courtesy
Obtains feedback to ensure customer needs are being met.
Builds long term relationships with customers.
Is committed to the customer's success.
Regularly receives positive feedback from customers.
Strategic Insight	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Identifies root causes of problems.
Ensures that the department's goals are strategically aligned with the company's goals.
Allocates proper resources for employee training to meet future needs based on insight into employee skill levels.
Understands the Company's strengths and weaknesses and uses this information to create optimal solutions to problems.
Implements long-term solutions to problems.
Vision	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Committed to turning the strategic vision into reality by meticulously planning, coordinating, and overseeing the implementation of an action plan.
Develops an inspiring and ambitious vision of growth for the organization's future.
Stays ahead of the curve and guides the team towards innovative solutions and strategic decisions.
Crafts a compelling vision that motivates employees to align their efforts with the organization's goals.
Models a strategic vision based on insights gained from in depth investigations into the performance of the company.

31. Overall, please rate the effectiveness of [Participant Name Here].
    

    5- Very Effective 4- Effective 3- Neither 2- Ineffective 1- Very Ineffective

    
    
32. Strengths
    
    
    
33. Areas for Development
    
    
    
34. Please give any final comments or suggestions for [Participant Name Here]'s assessment.