Flexibility - 360 Degree Feedback Survey Sample #5

360-Degree Assessment Survey

Dear Employee:

Thank you for participating in a 360-degree feedback assessment. In this process, you will complete a self-assessment questionnaire (below). You will also receive feedback from others including your manager, peers and direct reports. As you respond, please respond using just your experiences in the past 12 months. Rate each item using the scale shown. Comments can be very helpful; at a minimum where you give a particularly high or low rating, please share your reasons in the Closing Comments section. Your responses will be compiled with feedback from others and presented to you at the conclusion of this assessment to help guide your ongoing professional 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.

Please ensure that your submission is made by .

Thank you for your participation in the survey.

Management Team

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Flexibility	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You are open to and values diverse perspectives.
You scale up production capabilities in response to growing service demands.
I allow workflows to evolve with the employees' creativity.
I am able to work in multiple environments as needed.
You adapt workflows according to changing needs.
Self Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You do not allow own emotions to interfere with the performance of others.
You deal with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
You use patience and self-control in working with customers and associates.
You analyze own reactions on the spot to ensure that communication does not appear to be driven by anger.
You set an example for associates during stressful periods by maintaining a positive, can-do attitude.
Objectives	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You assure [Company] principles are understood, employed & pursued.
You set long-term and short-term goals.
You consistently provide me with timely feedback for improving my performance.
You work toward achieving established goals and objectives.
You are able to establish realistic goals.
Collaboration	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You create an environment that encourages information sharing.
You use group decision making.
You ensure relevant data is available to all committee members.
You collaborate in time, effort, and expertise to help achieve success.
I build a culture of trust and mutual respect where team members are encouraged to value each other's contributions.
Trustworthy	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You consistently keep commitments.
You demonstrate a sense of responsibility and commitment to public trust.
You are a person others can count on.
You take care to maintain confidential information.
You build and maintain the trust of others.
Strategic Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You effectively translate strategy into operational decisions.
You create strategic objectives to increase revenue and profit margins.
make strategic decisions that take into account a dynamic situation.
I develop a strategic plan to focus on strategic issues.
I use strategic thinking to make better strategic decisions.
Planning	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You have developed an effective strategic plan.
You assess the potential impact of changes to the strategic plan.
I ensure staff have the supplies and resources necessary to enact the plan.
You regularly make plans for contingencies.
You create to-do lists to make sure nothing is missed.

36. Overall, please rate the effectiveness of [Participant Name Here].
    

    5- Very Effective 4- Effective 3- Neither 2- Ineffective 1- Very Ineffective

    
    
37. Strengths
    
    
    
38. Areas for Development
    
    
    
39. Please give any final comments or suggestions for [Participant Name Here]'s assessment.