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

• Accepts the views of others.
• Seeks feedback to enhance performance.
• Looks to others for input.
• Actively seeks feedback from others.
• Is easy to approach with ideas and opinions.

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

Comments:

Passion To Learn

• Takes initiative for own learning and development.
• Embraces new technology and procedures.
• Recognizes own areas for development and consciously seeks assignments that will provide practice in areas of developmental need.
• Will participate in training classes even if offered outside of normal working hours.
• Holds self and associates accountable for goal achievement.

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

Comments:

Adaptability

• Adjusts priorities to the new Corporate mission.
• Adapts quickly to new situations.
• Ability to recognize the potential benefits of change, and create an infrastructure which supports change.
• Embraces change and fosters an open-minded environment.
• Continually trying to improve skills to remain current.

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

Comments:

Change Management

• Supports new initiatives for organizational changes to improve effectiveness.
• Inspires others to accept changes.
• Develops a strategy for implementing changes.
• Addresses organizational and departmental resistance to changes.
• Inspires others to want to change.

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

Comments:

Innovation

• Offers constructive improvements to existing systems.
• Encourages open communication to ensure that all proposals are considered.
• Suggests new ideas at meetings.
• Finds creative ways to get things done with limited resources.
• Searches for opportunities and innovative ways to improve the organization.

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.