Feedback - 360 Degree Feedback Survey Sample #5

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
Shares past experiences with others as learning opportunities.
Considers other's opinion and suggestions.
Open to the suggestions of others.
Looks to others for input.
Actively seeks feedback from others.
Attitude	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Treats all people fairly and with respect.
Builds open and trusting relationships.
Shows by their actions that they trust in the positive intentions of others.
Visibly supports and encourages diversity in style and background.
Contributes to a positive and fun work environment.
Trustworthy	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Builds and maintains the trust of others.
Demonstrates a sense of responsibility and commitment to public trust.
Takes ownership, delivers on commitments
Consistently keeps commitments.
Seeks to mitigate grievances by clarifying intentions and finding suitable remedies.
Customer Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
...friendliness and courtesy
Does not hesitate to address customer concerns or complaints.
Ensures all customer commitments and requirements are met or exceeded.
Develops good rapport and trust with the customer.
Consistently models positive customer service attitudes.
Strategic Insight	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Analyzes records and reports to obtain insight into potential issues and trends.
Anticipates business cycles and trends and makes adjustments in a timely manner.
Communicates vision for the department and company.
Understands the Company's strengths and weaknesses and uses this information to create optimal solutions to problems.
Maintains knowledge of current trends in the industry.
Vision	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Behaves in a way that is consistent with business values & code of conduct
Clearly articulates a vision for his/her work and inspires others to support it
Creates a positive vision of the future for the Company.
Communicates a vision of where the Company needs to be in the future.
Expresses the Company vision in a way that is easily understood and adopted by employees.

31. Overall, please rate the effectiveness of .
    

    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 's assessment.