Initiative - 360 Degree Feedback Survey Sample #8

Instructions

You have been selected to provide feedback for the manager listed above. Your feedback is an important part of 's leadership development process. This tool is intended to gather broad feedback in the core competencies and role responsibilities that are important for the on-going success of our organization.

In responding to the assessment form, please think about your experiences working with this individual during the last six to twelve months. Your responses will be merged with other people's feedback and presented to guide them in their on-going development. Comments will be shared anonymously, as written, with the manager.

Method of use: As part of the review process, managers will receive feedback from peers and staff. It is recognized that not all participants will be able to assess an individual's performance in all areas. The feedback received will be utilized as input to the manager's performance and on-going development plan.

You may sign out at any time by pressing the Save button at the end of the form and then closing your browser. You may return later to pick up where you left off. When you are done, press the Complete button.



Please complete your response by .

Initiative	Agree	Unsure	Disagree	N/A
Takes corrective action to address performance deficiencies/issues.
Cleans the workspace without being told.
Acts independently to solve pressing needs.
Engages with new customers immediately.
Takes charge when there is a crisis.
Change Management	Agree	Unsure	Disagree	N/A
Develops plans for following through on the changes.
Able to get team members to change their attitudes.
Supports the Company's efforts to implement changes.
Supports new initiatives for organizational changes to improve effectiveness.
Inspires others to accept changes.
Flexibility	Agree	Unsure	Disagree	N/A
Implements changes as a result of having listened to employees
Works effectively during periods of change.
Is open to alternative ways to accomplish goals
Can handle changes without complaining.
Acts decisively in frequently changing and uncertain environment.
Bias for Action	Agree	Unsure	Disagree	N/A
Seeks and utilizes opportunities for continuous learning and self-development.
Encourages risk taking and experimentation to improve performance
Completes a large volume of work.
Motivates others to achieve or exceed goals
Projects a "can-do" attitude when interfacing with peers, subordinates and customers(especially during difficult and challenging times).
Self Management	Agree	Unsure	Disagree	N/A
Does not allow own emotions to interfere with the performance of others.
Analyzes interpersonal problems instead of reacting to them.
Consciously controls own negative emotions in order to keep team morale up.
Is aware of personal impact on others and adjusts behavior to create a positive leadership presence.
Uses patience and self-control in working with customers and associates.
Continual Learning	Agree	Unsure	Disagree	N/A
Views setbacks as opportunities to learn from.
Improves on their skill sets.
Takes charge of their training and skills enhancement.
Participates in regular training offered.
Pursues professional development opportunities when they arise.
Feedback	Agree	Unsure	Disagree	N/A
Actively seeks feedback from others.
Considers other's opinion and suggestions.
Seeks feedback to enhance performance.
Is easy to approach with ideas and opinions.
Open to the suggestions of others.
Technical	Agree	Unsure	Disagree	N/A
Uses expertise to identify issues and think through creative solutions to get a problem solved or objective accomplished.
Is naturally sought out by people outside his/her particular area for advice and opinion on a broad range of matters - not necessarily solely legal advice.
Demonstrates mastery of the technical competencies required in his/her work.
Willingly shares his/her technical expertise; sought out as resource by others
Willingly shares information and expertise; sought out as resource by others
Objectives	Agree	Unsure	Disagree	N/A
Communicates goals and objectives to employees.
Sets long-term and short-term goals.
Establishes goals and objectives.
Assures [Company] principles are understood, employed & pursued.
Consistently provides me with timely feedback for improving my performance.
Responsible	Agree	Unsure	Disagree	N/A
Sets a good example
Behavior is ethical and honest.
Is a person you can trust.
Sets high personal standards of performance.
Holds herself / himself accountable to goals / objectives
Partnering/Networking	Agree	Unsure	Disagree	N/A
Promotes the understanding of how the department affects the organization overall.
Partners with peers to obtain influence within the Company.
Forges mutually beneficial relationships between individuals with diverse backgrounds.
Capitalizes on partnerships and networks to enhance the Company's bottom line.
Supports and encourages relationships that are created by diverse team members.
Strategic Focus	Agree	Unsure	Disagree	N/A
Exhibits a strategic orientation to identify and capitalize on opportunities to advance the organization.
Aligns projects to the strategic goals of the company.
Turns strategic priorities into action plans.
Effective in strategy formulation and execution.
Makes plans to handle unforeseen events that could impact the achievement of strategic goals.

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

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

    
    
62. Strengths
    
    
    
63. Areas for Development
    
    
    
64. Please give any final comments or suggestions for [Participant Name Here]'s assessment.