Feedback - 360 Degree Feedback Survey Sample #12

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.

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Feedback

• Open to the suggestions of others.
• Is easy to approach with ideas and opinions.
• Shares past experiences with others as learning opportunities.
• Accepts the views of others.
• Seeks feedback to enhance performance.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Passion To Learn

• Embraces new technology and procedures.
• Creates an environment that supports personal development and exploration.
• Holds self and associates accountable for goal achievement.
• Inspires others to learn new things.
• Will participate in training classes even if offered outside of normal working hours.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Adaptability

• Adjusts priorities to changing business goals.
• Effective in working with different personnel of the team.
• Is flexible and open minded in dealing with others.
• Handles unexpected events without a loss of productivity.
• Works effectively in dynamic and changing work environments.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Change Management

• Inspires others to accept changes.
• Inspires others to want to change.
• Able to get team members to change their attitudes.
• Adopts changes to set and example for others to follow.
• Works cooperatively with others to implement changes.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Innovation

• Transforms raw ideas into actionable plans with a higher likelihood of successful implementation.
• Pursues innovative approaches to the current policies and procedures.
• Analyzes current procedures and identifies opportunities for improvement.
• Coordinates the activities of the innovation steering committee.
• Focuses on bottom-up innovative efforts.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Strengths


Areas for Development


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