Integrity - 360 Degree Feedback Survey Sample #5

360-Degree Assessment Survey

Dear Employee:

Thank you for providing feedback for the recipient above. As you respond, please draw on your first-hand experience with this individual in the past 12 months. Rate each item using the scale shown. If you don't feel you have enough first-hand information to rate a certain item, please choose the Not Applicable option. Comments can be very helpful; at a minimum where you give a particularly high or low rating, please share your reasons in the Closing Comments section. Your responses will be compiled with feedback from others and presented to the recipient to help guide their ongoing development.

Partially completed forms can be saved by using the Save/Still Working button at the bottom of the page. You may return at a later time to complete/edit the form. Your saved responses will be shown each time you re-visit the feedback form. When you are certain that you have completed your responses and will be not making any changes, click the Complete button.

Please ensure that your submission is made by .

Thank you for your participation in the survey.

Management Team

Integrity	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Demonstrates sincerity in actions with others.
Develops trust and confidence from others.
Protects the integrity and confidentiality of information
Follows tasks to completion.
Maintains strong relationships with others.
Passion To Learn	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Embraces new technology and procedures.
Demonstrates a willingness to participate in continuing education courses.
Demonstrates through personal behavior the commitment to high standards of performance.
Will participate in training classes even if offered outside of normal working hours.
Exhibits willingness to upgrade skills through additional training and education.
Creativity	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Develops solutions to challenging problems.
Is creative.
Creates a lot of new ideas.
Is creative and inspirational.
Inspires creativity in their team.
Feedback	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Open to the suggestions of others.
Is visible and approachable.
Looks to others for input.
Seeks feedback to enhance performance.
Is easy to approach with ideas and opinions.
Establishing Focus/Direction	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Maintains focus when handling several problems or tasks simultaneously.
Makes sure that employees understand how their work relates to organizational goals.
Helps guide employees with prioritizing tasks.
Maintains self-control when personally criticized.
Sets appropriate goals for employees.
Objectives	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Able to organize work.
Consistently provides me with timely feedback for improving my performance.
Effectively organizes resources and plans
Encourages me to take on greater responsibility.
Ability to establish realistic goals.
Co-worker Development	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Gives others development opportunities through project assignments and increased job responsibilities
Works to identify root causes of performance problems
Adapts coaching and mentoring approach to meet the style or needs of individuals
Sets and clearly communicates expectations, performance goals, and measurements to others
Takes immediate action on poor performance
Negotiation	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Leverages relationships with others to achieve goals.
Resolves difficult negotiations whether it is a contract, sub contract, legal or any other difficult negotiation fairly and reasonably.
Able to influence others to accept certain positions.
Maintains communication channels between parties in the negotiation.
Stays calm and focuses on the core issues to be discussed.
Strategic Insight	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Maintains knowledge of current trends in the industry.
Analyzes records and reports to obtain insight into potential issues and trends.
Formulates strategies and action plans to ensure successful completion of goals and objectives.
Understands the Company's strengths and weaknesses and uses this information to create optimal solutions to problems.
Analyzes unique issues or problems impacting the Company.

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

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

    
    
47. Strengths
    
    
    
48. Areas for Development
    
    
    
49. Please give any final comments or suggestions for [Participant Name Here]'s assessment.