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 the initiative to change the direction or course of events.
Seeks and utilizes opportunities for continuous learning and self-development.
Immediately works to complete goals well before their deadline.
Goes above and beyond the stated goals.
Takes decisive action to address problems, following up with relevant team members and coaching them on how to improve.
Change Management	Agree	Unsure	Disagree	N/A
Adopts changes to set and example for others to follow.
Addresses organizational and departmental resistance to changes.
Assists others in understanding changes to the organization.
Effective in implementing new organizational vision and values.
Effective in dealing with ambiguous and challenging situations.
Flexibility	Agree	Unsure	Disagree	N/A
Can handle changes without complaining.
Adapts to new organizational structures, policies, or procedures.
Is open to alternative ways to accomplish goals
Open to the perspectives/viewpoints of others.
Works effectively during periods of change.
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
Conveys a sense of urgency about addressing problems and opportunities
Projects a "can-do" attitude when interfacing with peers, subordinates and customers(especially during difficult and challenging times).
Motivates others to achieve or exceed goals
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.
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.
Uses patience and self-control in working with customers and associates.
Continual Learning	Agree	Unsure	Disagree	N/A
Seeks opportunities to grow in skills and knowledge.
Is open to new ideas and concepts.
Participates in regular training offered.
Pursues self-improvement through continual learning.
Builds on their strengths while addressing their weaknesses.
Feedback	Agree	Unsure	Disagree	N/A
Is easy to approach with ideas and opinions.
Open to the suggestions of others.
Actively seeks feedback from others.
Is visible and approachable.
Asks others for their ideas and opinions.
Technical	Agree	Unsure	Disagree	N/A
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.
Willingly shares his/her technical expertise; sought out as resource by others
Knows how to produce high quality products/work.
Demonstrates mastery of the technical competencies required in his/her work.
Willingly shares information and expertise; sought out as resource by others
Objectives	Agree	Unsure	Disagree	N/A
Encourages me to take on greater responsibility.
Communicates goals and objectives to employees.
Ability to establish realistic goals.
Sets long-term and short-term goals.
Assures [Company] principles are understood, employed & pursued.
Responsible	Agree	Unsure	Disagree	N/A
Sets a good example
Behavior is ethical and honest.
Acts as a resource without removing individual responsibility.
Holds herself / himself accountable to goals / objectives
Responsible for setting the vision of the department.
Partnering/Networking	Agree	Unsure	Disagree	N/A
Supports a partnering/networking culture.
Creates value within the Company by building networks.
Collaborates with others to accomplish goals and objectives.
Builds alliances between departments and teams.
Maintains infrastructure to support partnerships and networks.
Strategic Focus	Agree	Unsure	Disagree	N/A
Monitors performance of each market within the Area, utilizing reports to ensure sales growth, cost management, and profitability targets are met.
Able to decline a poor strategy by proposing alternate strategies.
Creates plans to develop and promote organizational and area strengths, as well as to address weaknesses.
Understands their role within the organization.
Sustains or achieves a competitive advantage for the organization by analyzing the best practices and lessons learned from other organizations.

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.