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.
Open to the suggestions of others.
Asks others for their ideas and opinions.
Considers other's opinion and suggestions.
Attitude	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Contributes to a positive and fun work environment.
Visibly supports and encourages diversity in style and background.
Builds open and trusting relationships.
Is gracious and professional in their interactions with others.
Shows by their actions that they trust in the positive intentions of others.
Trustworthy	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Demonstrates congruence between statements and actions.
Is trustworthy; is someone I can trust.
Consistently keeps commitments.
Takes care to maintain confidential information.
Seeks to mitigate grievances by clarifying intentions and finding suitable remedies.
Customer Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Is aware of what the customer wants to receive.
Ensures customers' expectations are met or exceeded.
Documents customer interactions.
Prioritizes the needs and preferences of the customer.
Addresses customer complaints immediately.
Strategic Insight	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Strategically aligns projects to the goals of the company.
Attends industry conferences to gain further insight into how other companies deal with similar issues.
Maintains knowledge of current trends in the industry.
Identifies root causes of problems.
Understands how to strategically grow the business and increase customers.
Vision	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Demonstrates consistency between words and actions
Works to support the strategy of [Company]
Transforms the department's vision into a clearly defined, actionable set of goals and a comprehensive strategic plan.
Charts a bold course for the department's rapid evolution and expansion.
Establishes the direction and strategy for the organization.

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.