Feedback - 360 Degree Feedback Survey Sample #11

360 Feedback Survey

Instructions

We appreciate you taking the time to provide valuable feedback for the individual mentioned above. As you respond, please draw on your first-hand experience with this individual in the past 12 months. Your insights are crucial in offering a comprehensive evaluation. Please rate each item using the scale provided. If you find that you do not have sufficient first-hand knowledge to rate a particular item, select the Not Applicable option.

In addition to the ratings, we encourage you to include comments where possible. These comments are particularly useful when you give a very high or very low rating, as they provide context and clarity regarding your assessment. Explaining your reasons in the comment section helps ensure that your feedback is constructive and actionable.

Your responses, combined with feedback from other contributors, will be compiled and presented to the individual. This collective feedback aims to support their continuous growth and development by highlighting strengths and identifying areas for improvement. Your thoughtful participation is essential in helping them achieve their full potential.

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.

To what extent does [Participant Name] exhibit the following ...

SELECT the rating that best reflects the employee's performance in the areas listed.

Edit this Survey

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Feedback

What does Feedback mean?
It means that ...

• You consider other's opinion and suggestions.
• You ask others for their ideas and opinions.
• You are open to the suggestions of others.
• You are easy to approach with ideas and opinions.
• You share past experiences with others as learning opportunities.

To what extent does this person exhibit Feedback?
Select from one of the ratings below.

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Project Management

What does Project Management mean?
It means that ...

• You determine the roles for project team members.
• You have detailed knowledge about the project and can adapt the project plan as needed.
• You present clear and accurate status information to required constituents.
• You use appropriate technology to efficiently communicate with team members.
• You determine the project strategy for implementation.

To what extent does this person exhibit Project Management?
Select from one of the ratings below.

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Decision Making

What does Decision Making mean?
It means that ...

• You break complex issues into manageable parts and organize them in a systematic way before making decisions
• You have a good rapport other people which is helpful in making decisions on the team.
• You understand factors are important for deciding if a decision is "worth it"?
• You apply creative reasoning in making decisions.
• You do not lose sight of the big picture when making decisions

To what extent does this person exhibit Decision Making?
Select from one of the ratings below.

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Safety

What does Safety mean?
It means that ...

• You are not afraid to question a potential safety issue observed in the workplace.
• You ensure that all supervisors are aware of regulatory and compliance measures.
• You work to implement corrective safety measures.
• You are committed to safety in the workplace.
• You seek to reduce the likelihood of accidents.

To what extent does this person exhibit Safety?
Select from one of the ratings below.

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Co-worker Development

What does Co-worker Development mean?
It means that ...

• You provide ongoing feedback to co-workers on your development progress
• You set and clearly communicate expectations, performance goals, and measurements to others
• You adapt coaching and mentoring approach to meet the style or needs of individuals
• You take immediate action on poor performance
• You work to identify root causes of performance problems

To what extent does this person exhibit Co-worker Development?
Select from one of the ratings below.

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Strengths


Areas for Development


Please give any final comments or suggestions for [Participant Name Here]'s assessment.