Innovation - 360 Degree Feedback Survey Sample #7

360 Feedback Survey

Self-Assessment Form Instructions

is administering a new web-based survey tool which is designed to gather broad feedback as it relates to core competencies and role responsibilities that are important for the on-going success of our organization. All Leadership Team Members will be participating at this time.

In this regard, you need to complete a self-assessment questionnaire form (below).
Your responses will be combined with the responses from your peers and direct reports. 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 twelve (12) 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, unless you indicate otherwise.

You are only being asked to rate 8 competencies. Each competency will have a variety of statements that are grouped by 4 Performance Levels. Click on the level that best describes this individual.

Please ensure that your submission is made between .

Innovation	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
You take risks to advance important ideas.
You create improved methods or solutions for meeting goals and objectives.
You analyze current procedures and identify opportunities for improvement.
You solve problems with insight and understanding.
You suggest new ideas at meetings.
If you were to make improvements in Innovation, what are your suggestions for how you can improve this?
Clarity	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
You communicate ideas and facts clearly and effectively in writing.
You adjust communication methods to the needs of the audience.
You communicate with clarity and efficiency.
You write clear job descriptions for positions in the organization.
You make sure goals and objectives are clearly and thoroughly explained and understood.
If you were to make improvements in Clarity, what are your suggestions for how you can improve this?
Creativity	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
You create a lot of new ideas.
You develop solutions to challenging problems.
You inspire creativity in your team.
You add value to the department/organization.
You conceive, implement and evaluate ideas.
If you were to make improvements in Creativity, what are your suggestions for how you can improve this?
Professional Development	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
You quickly acquire and apply new knowledge and skills when needed
You are contributing fully to the extent of your skills
You demonstrate enthusiasm and a willingness to learn new skills and knowledge
You encourage employees to take courses relevant to their job.
You seek opportunities for continuous learning.
If you were to make improvements in Professional Development, what are your suggestions for how you can improve this?
Empowering Others	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
I acknowledge and appreciate employees for their proactive decision-making.
You give employees autonomy to complete tasks on their own.
You allow individuals to be responsible for their decisions.
I foster a sense of ownership and accountability for the process/product.
You enable team members to make their own decisions on the project.
If you were to make improvements in Empowering Others, what are your suggestions for how you can improve this?
Global Perspective	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
You create an environment where individual differences are valued and supported.
You can effectively deliver presentations to international clients.
You understand global systems such as the global economy.
You attend training seminars and conferences to increase skills in working with others globally.
You demonstrate a curiosity about diverse individuals and cultures.
If you were to make improvements in Global Perspective, what are your suggestions for how you can improve this?

31. Strengths
    
    
    
32. Areas for Development
    
    
    
33. Please give any final comments or suggestions for [Participant Name Here]'s assessment.