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
Actively seeks feedback from others.
Accepts the views of others.
Seeks feedback to enhance performance.
Is easy to approach with ideas and opinions.
Considers other's opinion and suggestions.
Attitude	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Visibly supports and encourages diversity in style and background.
Contributes to a positive work environment.
Shows by their actions that they trust in the positive intentions of others.
Treats all people fairly and with respect.
Works to eliminate unnecessary work or barriers that get in others' way.
Trustworthy	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Builds and maintains the trust of others.
Seeks to mitigate grievances by clarifying intentions and finding suitable remedies.
Communicates an understanding of the other person's interests, needs and concerns.
Demonstrates a sense of responsibility and commitment to public trust.
Delivers on promises made.
Customer Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Identifies the most pressing needs of each customer.
Effectively troubleshoots customer issues.
Treats customers with courtesy and respect.
Responsive to customer needs.
Provides a high level of service to customers.
Strategic Insight	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Adjusts strategic plans based on insights gathered from different points of view.
Observes employees at work to get better insight into the issues they are dealing with.
Converses with customers and clients to get a better insight into their personal needs.
Recognizes the needs of customers.
Creates a mission statement describing the purpose for the organization.
Vision	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Develops action plans to align his/her work with the goals of the organization
Communicates the vision and strategy of [Company]
Demonstrates consistency between words and actions
Expresses the Company vision in a way that is easily understood and adopted by employees.
Understands the vision of the Company and promotes it ahead of any self-interests.

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.