Feedback - 360 Degree Feedback Survey Sample #12

360 Feedback Survey

Instructions

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 comment section for that competency. Your responses will be compiled with feedback from others and presented to the recipient to help guide their ongoing development.

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.

Feedback

• Looks to others for input.
• Asks others for their ideas and opinions.
• Open to the suggestions of others.
• Considers other's opinion and suggestions.
• Actively seeks feedback from others.

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

Comments:

Passion To Learn

• Takes advantage of training opportunities when they arise.
• Enhances value to the company through additional training and development.
• Constantly enhances product knowledge through experimentation and play.
• Demonstrates through personal behavior the commitment to high standards of performance.
• 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

• Is open to changes in policies and procedures.
• Able to respond to incidents without stopping the workflow.
• Adjusts priorities to the new Corporate mission.
• Willing to change ideas or perceptions based on new information or contrary evidence which is presented.
• Able to step in and help co-workers when needed.

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

Comments:

Change Management

• Able to get department employees to accept new changes.
• Is an inspiration for others to accept the recent changes.
• Inspires others to want to change.
• Able to get team members to change their attitudes.
• Supports the Company's efforts to implement changes.

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

Comments:

Innovation

• Builds upon the ideas and solutions of others.
• Solves problems with insight and understanding.
• Challenges current procedures to develop other alternatives.
• Suggests new ideas at meetings.
• Encourages open communication to ensure that all proposals are considered.

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.