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.



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Initiative	Agree	Unsure	Disagree	N/A
Capitalizes on opportunities as they become available.
Looks for opportunities to move projects forward.
Gladly seeks additional responsibilities.
Acts independently to solve pressing needs.
Takes charge when there is a crisis.
Change Management	Agree	Unsure	Disagree	N/A
Supports new initiatives for organizational changes to improve effectiveness.
Addresses organizational and departmental resistance to changes.
Able to get team members to change their attitudes.
Able to get department employees to accept new changes.
Develops plans for following through on the changes.
Flexibility	Agree	Unsure	Disagree	N/A
Allows for flexibility in setting realistic performance goals.
Anticipates differences to the procedures that may be needed due to a changing operating environment.
Navigates ambiguity with ease, maintaining focus and productivity amidst uncertainty.
Is able to bounce back from obstacles.
Able to make changes to their leadership style after receiving constructive feedback through the performance review.
Bias for Action	Agree	Unsure	Disagree	N/A
Encourages risk taking and experimentation to improve performance
Completes work on time
Completes a large volume of work.
Conveys a sense of urgency about addressing problems and opportunities
Displays high energy and enthusiasm on consistent basis.
Self Management	Agree	Unsure	Disagree	N/A
Analyzes own reactions on the spot to ensure that communication does not appear to be driven by anger.
Deals with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
Does not allow own emotions to interfere with the performance of others.
Is aware of personal impact on others and adjusts behavior to create a positive leadership presence.
Steps away from a situation to process appropriate response.
Continual Learning	Agree	Unsure	Disagree	N/A
Pursues self-improvement through continual learning.
Grasps new ideas, concepts, technical, or business knowledge.
Builds on their strengths while addressing their weaknesses.
Shares best practices with others and learns from others.
Pursues learning that will enhance job performance.
Feedback	Agree	Unsure	Disagree	N/A
Asks others for their ideas and opinions.
Accepts the views of others.
Shares past experiences with others as learning opportunities.
Considers other's opinion and suggestions.
Seeks feedback to enhance performance.
Technical	Agree	Unsure	Disagree	N/A
Willingly shares his/her technical expertise; sought out as resource by others
Demonstrates mastery of the technical competencies required in his/her work.
Uses expertise to identify issues and think through creative solutions to get a problem solved or objective accomplished.
Seeks information from others as needed.
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.
Objectives	Agree	Unsure	Disagree	N/A
Sets long-term and short-term goals.
Encourages me to take on greater responsibility.
Ability to establish realistic goals.
Establishes goals and objectives.
Communicates goals and objectives to employees.
Responsible	Agree	Unsure	Disagree	N/A
...takes personal responsibility for results.
Sets a good example
Is a person you can trust.
Sets high personal standards of performance.
Acts as a resource without removing individual responsibility.
Partnering/Networking	Agree	Unsure	Disagree	N/A
Develops trust in others to form partnerships and networks.
Exchanges innovative ideas with a network of colleagues.
Provides or participates in joint ventures or co-development projects.
Strives to cultivate and maintain a partnership based on trust and commitment in relationships.
Reinforces the contacts with other organizations.
Strategic Focus	Agree	Unsure	Disagree	N/A
Understands how to grow the business and increase customers.
Sustains or achieves a competitive advantage for the organization by analyzing the best practices and lessons learned from other organizations.
Maintains a strategic focus on external factors impacting the success of the company.
Makes quick and creative decisions to adjust the strategy to meet the demands of changing situations.
Strategically focuses efforts to improve operational efficiencies.

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.