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
Seeks feedback to enhance performance.
Accepts the views of others.
Is visible and approachable.
Is easy to approach with ideas and opinions.
Actively seeks feedback from others.
Attitude	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Builds open and trusting relationships.
Shows by their actions that they trust in the positive intentions of others.
Contributes to a positive work environment.
Contributes to a positive and fun work environment.
Is gracious and professional in their interactions with others.
Trustworthy	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Is trustworthy; is someone I can trust.
Demonstrates congruence between statements and actions.
Delivers on promises made.
Seeks to mitigate grievances by clarifying intentions and finding suitable remedies.
Demonstrates a sense of responsibility and commitment to public trust.
Customer Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Exceeds expectations of the customers.
Is committed to the customer's success.
Builds long term relationships with customers.
Accepts responsibility for ensuring customer satisfaction.
Helps others in responding to customer needs.
Strategic Insight	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Creates a vision for the organization based on insights gathered from other companies in the industry.
Creates a mission statement describing the purpose for the organization.
Attends industry conferences to gain further insight into how other companies deal with similar issues.
Understands how to strategically grow the business and increase customers.
Develops a plan and strategy for each functional area within the mission statement.
Vision	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Detects problems and creates solutions.
Envisions and articulates a clear path for the department's growth over the next year.
Fosters a leadership vision that promotes innovation and growth.
Creates a common vision for others.
Diagnoses issues and envisions solutions.

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.