Interpersonal Skills - 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

Interpersonal Skills	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Builds a strong rapport with co-workers.
Is a role model for others
Successfully resolves conflicts and grievances to a win-win solution.
Demonstrates compassion and understanding of others.
Anticipates the concerns of other employees.
Communication Skills	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Listens to others' points of view with an open mind
Communicates with department leadership
An effective listener who is responsive to information needs.
Presents issues, ideas, and strategy concisely and clearly.
Delivers influential presentations.
Supervisory Skills	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Provides direction and coaching to employees.
Resolves disputes in a way that quickly reaches mutual agreement.
Communicates effectively with employees.
Fosters an environment that supports open communication.
Demonstrates empathy, respect, and openness to employees.
Professional Development	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Quickly acquire and apply new knowledge and skills when needed
Contributing fully to the extent of their skills
Seeks opportunities for professional development.
Seeks opportunities for continuous learning.
Allows employees to fully participate in employee training and professional development.
Feedback	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Is easy to approach with ideas and opinions.
Seeks feedback to enhance performance.
Considers other's opinion and suggestions.
Is visible and approachable.
Actively seeks feedback from others.
Analytical	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Identifies the root cause of a problem.
Analyzes issues and reduces them to their component parts.
Balances risks and costs with the rewards and probabilities of success when decisions.
Asks the "right" questions to size up or evaluate situations.
Prioritizes various actions to be taken when solving a problem.
Initiative	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Capitalizes on opportunities as they become available.
Helps the department take the initiative to create new solutions.
Initiates projects that have an impact on the department.
Able to initiate work on projects independently without direct supervision.
Encourages others on the team to suggest process improvements.
Vision	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Creates a common vision for others.
Understands the vision of the Company and promotes it ahead of any self-interests.
Expresses the Company vision in a way that is easily understood and adopted by employees.
Persuades others to follow the Company's vision.
Develops action plans to align his/her work with the goals of the organization

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

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

    
    
42. Strengths
    
    
    
43. Areas for Development
    
    
    
44. Please give any final comments or suggestions for [Participant Name Here]'s assessment.