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

Flexibility	Role Model	Capable and Effective	Somewhat Effective	Needs Development
I introduce new products or services.
I anticipate differences to the procedures that may be needed due to a changing operating environment.
I adapt strategies to fit the specific needs of each situation.
You encourage adaptability to utilize more efficient processes.
You demonstrate flexibility in thoughts and actions.
Self Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You step away from a situation to process appropriate response.
You use patience and self-control in working with customers and associates.
You are aware of personal impact on others and adjusts behavior to create a positive leadership presence.
You do not allow own emotions to interfere with the performance of others.
You analyze interpersonal problems instead of reacting to them.
Objectives	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You encourage others to take on greater responsibility.
You consistently provide me with timely feedback for improving my performance.
You are able to organize work.
You organize and schedules events, activities, and resources.
You communicate goals and objectives to employees.
Collaboration	Role Model	Capable and Effective	Somewhat Effective	Needs Development
I share knowledge, ideas and resources to achieve quicker success.
I use effective strategies to re-engage team members and secure their commitment to the business's common good.
I avoid promoting a hyper competitive culture in favor of a more collaborative one.
I develop networks and builds alliances across departments.
You build consensus among team members.
Trustworthy	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You take ownership, deliver on commitments
You work in a way that makes others want to work with you.
You take care to maintain confidential information.
You communicate an understanding of the other person's interests, needs and concerns.
You are a person others can count on.
Strategic Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
I develop high-level strategic planning models to identify opportunities to improve the company.
I develop strategies that are practical and can be feasibly implemented within a reasonable period of time.
You look for opportunities to enhance contributions to the bottom line.
You identify bottlenecks in the production process and develops strategies to correct these issues.
You strategically deploy resources to areas of the greatest need.
Planning	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You establish a course of action for self and others to accomplish specific goals.
I can develop good plans used for logistics.
You have developed an effective strategic plan.
You notify staff when the plan is not on schedule.
I make strategic and tactical decisions to guide the logistics process.

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.