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

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

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

Comments:

Passion To Learn

• Constantly enhances product knowledge through experimentation and play.
• Critiques own performance and learns from experience as a source of continuous improvement.
• Recognizes own areas for development and consciously seeks assignments that will provide practice in areas of developmental need.
• Demonstrates through personal behavior the commitment to high standards of performance.
• Takes initiative for own learning and development.

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

Comments:

Adaptability

• Works effectively in dynamic and changing work environments.
• Willing to change ideas or perceptions based on new information or contrary evidence which is presented.
• Is flexible and open minded in dealing with others.
• Develops insights and applies innovative solutions to projects and problems.
• Performs a wide range of tasks, responds to changes in direction and priorities and accepts new challenges, responsibilities, and assignments.

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

Comments:

Change Management

• Adopts changes to set and example for others to follow.
• Supports the Company's efforts to implement changes.
• Works cooperatively with others to implement changes.
• Supports new initiatives for organizational changes to improve effectiveness.
• Addresses organizational and departmental resistance to changes.

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

Comments:

Innovation

• Challenges current procedures to develop other alternatives.
• Creates a safe environment for idea-sharing.
• Suggests new ideas at meetings.
• Offers constructive improvements to existing systems.
• Analyzes current procedures and identifies opportunities for improvement.

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.