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.

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.

Please ensure that your submission is made by .

Thank you for your participation in the survey.

Management Team

Edit this Survey

Would you like to edit this survey? Click here to begin.

Feedback	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Hosts training sessions on communication skills, supplying self-assessment tools, and setting up feedback systems.
Regards feedback as a beneficial opportunity.
Considers feedback as a positive and enriching process.
Invites and values input from others to gain a more comprehensive understanding of their abilities and areas where they can develop further.
Promotes an atmosphere that champions continuous education and enhancement.
Attitude	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Has a concern for employees in the department.
Approaches setbacks with a positive attitude.
Is willing to mentor and coach employees.
Enjoys discussing progress, especially in team meetings or performance reviews.
Always does their best effort on the job.
Trustworthy	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Demonstrates congruence between statements and actions.
Is a person you can trust.
Consistently keeps commitments.
Seeks to mitigate grievances by clarifying intentions and finding suitable remedies.
Communicates an understanding of the other person's interests, needs and concerns.
Customer Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Makes sure customer needs are understood by the team members.
Is committed to the success of the customer.
Meets with customers on a regular basis.
Thoroughly understands the needs of the customer.
Acts with integrity in all customer interactions.
Strategic Insight	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Strategically aligns projects to the goals of the company.
Ensures that the department's goals are strategically aligned with the company's goals.
Integrates financial, operational, and market data to guide strategic priorities and resource allocation.
Creates strategic plans to develop and promote organizational and area strengths, as well as to address weaknesses based on insight from surveys.
Adjusts strategic plans based on insights gathered from different points of view.
Vision	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Creates a vision to align corporate strategies with the organization's value system.
Enables employees to commit to the departmental vision.
Channels team activities towards the vision's core aspects.
Provides the vision needed to help the organization remain competitive and adaptable in a dynamic market.
Aligns subordinates' work with the vision's critical priorities.

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.