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
When working on a problem in a team, they are often the first to suggest possible solutions.
Takes decisive action to address problems, following up with relevant team members and coaching them on how to improve.
Capitalizes on opportunities as they become available.
Completes tasks without having to be told to do so.
Initiates draft reports for consideration.
Change Management	Agree	Unsure	Disagree	N/A
Assists others in understanding changes to the organization.
Inspires others to want to change.
Inspires others to accept changes.
Is an inspiration for others to accept the recent changes.
Effective in dealing with ambiguous and challenging situations.
Flexibility	Agree	Unsure	Disagree	N/A
Fosters a culture where diverse perspectives are valued allowing the team to adapt more easily to changes and draw on a wider range of ideas and solutions.
Effective in incorporating new ideas.
Capable of adapting workflows to accommodate new regulations or policies.
Is open to and values diverse perspectives.
Adapts strategies to fit the specific needs of each situation.
Bias for Action	Agree	Unsure	Disagree	N/A
Coach others to foster an environment which can adapt quickly and willingly to rapid change.
Conveys a sense of urgency about addressing problems and opportunities
Completes work on time
Encourages risk taking and experimentation to improve performance
Motivates others to achieve or exceed goals
Self Management	Agree	Unsure	Disagree	N/A
Analyzes interpersonal problems instead of reacting to them.
Analyzes own reactions on the spot to ensure that communication does not appear to be driven by anger.
Consciously controls own negative emotions in order to keep team morale up.
Uses patience and self-control in working with customers and associates.
Deals with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
Continual Learning	Agree	Unsure	Disagree	N/A
Grasps new ideas, concepts, technical, or business knowledge.
Takes the initiative to learn new skills.
Takes charge of their training and skills enhancement.
Pursues professional development opportunities when they arise.
Is open to new ideas and concepts.
Feedback	Agree	Unsure	Disagree	N/A
Open to the suggestions of others.
Asks others for their ideas and opinions.
Seeks feedback to enhance performance.
Looks to others for input.
Actively seeks feedback from others.
Technical	Agree	Unsure	Disagree	N/A
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.
Willingly shares information and expertise; sought out as resource by others
Is knowledgeable of procedures or systems necessary for the job.
Willingly shares his/her technical expertise; sought out as resource by others
Objectives	Agree	Unsure	Disagree	N/A
Organizes and schedules events, activities, and resources.
Consistently provides me with timely feedback for improving my performance.
Sets long-term and short-term goals.
Encourages me to take on greater responsibility.
Works toward achieving established goals and objectives.
Responsible	Agree	Unsure	Disagree	N/A
Sets a good example
Sets a good example.
Completes assigned work tasks.
Is a person you can trust.
Responsible for setting the vision of the department.
Partnering/Networking	Agree	Unsure	Disagree	N/A
Understands the potential implications of the partnership.
Finds common ground with a wide range of stakeholders.
Is comfortable working in partnership with colleagues from other departments.
Nurtures partnerships with key individuals in the industry to stay on top of the latest trends and best practices.
Maintains a strong track record of networking and partnering.
Strategic Focus	Agree	Unsure	Disagree	N/A
Inspires employees to adopt the strategic plan.
Strategically focuses efforts to improve operational efficiencies.
Determines the best strategy for achieving elevated levels of performance.
Creates a SWOT matrix to help analyze data.
Ensures that the department's goals are strategically aligned with the company's 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.