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
Is easy to approach with ideas and opinions.
Asks others for their ideas and opinions.
Open to the suggestions of others.
Shares past experiences with others as learning opportunities.
Accepts the views of others.
Attitude	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Contributes to a positive and fun work environment.
Builds open and trusting relationships.
Is gracious and professional in their interactions with others.
Visibly supports and encourages diversity in style and background.
Works to eliminate unnecessary work or barriers that get in others' way.
Trustworthy	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Communicates an understanding of the other person's interests, needs and concerns.
Demonstrates a sense of responsibility and commitment to public trust.
Is trustworthy; is someone I can trust.
Seeks to mitigate grievances by clarifying intentions and finding suitable remedies.
Builds and maintains the trust of others.
Customer Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
...friendliness and courtesy
Develops strong customer relationships.
Consistently models positive customer service attitudes.
Considers customers point of view when making decisions.
Asks questions and listens carefully to determine customer needs and to ensure that the customer's needs are met.
Strategic Insight	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Formulates strategies and action plans to ensure successful completion of goals and objectives.
Anticipates business cycles and trends and makes adjustments in a timely manner.
Maintains knowledge of current trends in the industry.
Analyzes records and reports to obtain insight into potential issues and trends.
Identifies root causes of problems.
Vision	Role Model	Capable and Effective	Somewhat Effective	Needs Development
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.
Creates a positive vision of the future for the Company.

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.