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
Accepts the views of others.
Considers other's opinion and suggestions.
Looks to others for input.
Is visible and approachable.
Is easy to approach with ideas and opinions.
Attitude	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Contributes to a positive and fun work environment.
Shows by their actions that they trust in the positive intentions of others.
Is gracious and professional in their interactions with others.
Builds open and trusting relationships.
Visibly supports and encourages diversity in style and background.
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.
Builds and maintains the trust of others.
Is trustworthy; is someone I can trust.
Is a person you can trust.
Customer Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Has received good feedback from customers.
Is committed to the success of the customer.
Makes customer's needs a top priority.
Consistently models positive customer service attitudes.
Does not hesitate to address customer concerns or complaints.
Strategic Insight	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Identifies root causes of problems.
Identifies potential problems before they become critical incidents.
Analyzes records and reports to obtain insight into potential issues and trends.
Anticipates business cycles and trends and makes adjustments in a timely manner.
Creates strategies that significantly benefit the Company.
Vision	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Clearly articulates a vision for his/her work and inspires others to support it
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.
Works to support the strategy of [Company]
Develops action plans to align his/her work with the goals of 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.