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.

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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
Adapts management style to meet the needs of the individual or situation.
Values the opinions of others.
Is a role model for others
Provides constructive feedback in a way that fosters acceptance and development.
Able to work with individuals at all levels of the Company.
Communication Skills	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Chooses the communication medium (ie. email, voice mail, memo, project document) that reflects the needs of the content. (ie. urgency, confidentiality, content scope)
Listens to others' points of view with an open mind
An effective listener who is responsive to information needs.
Able to deliver presentations.
Asks follow-up questions as needed.
Supervisory Skills	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Is aware of the unique strengths of each employee.
Treats all staff equitably.
Delegates effectively.
Appropriately recognizes and rewards employees.
Resolves personnel problems quickly and effectively.
Professional Development	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Keep themselves up-to-date of technical/professional issues
Demonstrate enthusiasm and a willingness to learn new skills and knowledge
Contributing fully to the extent of their skills
Seeks opportunities for professional development.
Quickly acquire and apply new knowledge and skills when needed
Feedback	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Looks to others for input.
Is easy to approach with ideas and opinions.
Shares past experiences with others as learning opportunities.
Open to the suggestions of others.
Asks others for their ideas and opinions.
Analytical	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Selects the appropriate techniques for analysis.
Analyzes issues and reduces them to their component parts.
Analyzes data and information from several sources and arrives at logical conclusions.
Balances risks and costs with the rewards and probabilities of success when decisions.
Identifies problems and issues needing resolution.
Initiative	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Prepares for unexpected contingencies.
Takes the initiative to change the direction or course of events.
Immediately works to complete goals well before their deadline.
Takes decisive action to address problems, following up with relevant team members and coaching them on how to improve.
Takes action without being asked.
Vision	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Communicates a vision of where the Company needs to be in the future.
Works to support the strategy of [Company]
Leads employees in new directions.
Demonstrates consistency between words and actions
Creates a positive vision of the future for the Company.

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.