Interpersonal Skills - 360 Degree Feedback Survey Sample #7

360 Feedback Survey

Instructions

We are requesting your participation in a 360-degree feedback review of several participants in our company's Leadership Development program. We are 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. The Leadership Team Members have agreed to participate and are seeking your feedback.

In this regard, you have been selected to provide feedback for the manager listed above. Your feedback is an important part of this manager'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.

You will get the chance to evaluate this manager's performance in different areas and share your thoughts through written comments for more detailed feedback. Ensure that your feedback is constructive and helpful.

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 .

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Interpersonal Skills	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Effectively manages conflicts by dealing with them directly and immediately
Creates diverse teams of individuals with different backgrounds, skills, and abilities.
Strives to lead by example to demonstrate the value of interpersonal relationships.
Responds quickly to inquiries from potential customers.
Applies appropriate communication techniques to the situation.
If [Participant Name] were to make improvements in Interpersonal Skills, what are your suggestions for how he/she can improve this?
Creativity	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Is able to bring out the best from creative and talented people.
Is creative and inspirational.
Creates imaginative prompts to inspire the team's idea generation.
Finds creative ways to meet the needs of patients.
Leads by example with imaginative thinking and innovative action.
If [Participant Name] were to make improvements in Creativity, what are your suggestions for how he/she can improve this?
Self Management	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Analyzes interpersonal problems instead of reacting to them.
Is aware of personal impact on others and adjusts behavior to create a positive leadership presence.
Does not allow own emotions to interfere with the performance of others.
Deals with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
Analyzes own reactions on the spot to ensure that communication does not appear to be driven by anger.
If [Participant Name] were to make improvements in Self Management, what are your suggestions for how he/she can improve this?
Feedback	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Provides support and resources, such as training programs, mentorship, or tools, to help employees develop the skills and knowledge required to implement these changes effectively.
Works with others to ensure a smooth feedback process.
Schedules regular check-ins to ensure feedback is ongoing, even between formal reviews.
Seeks feedback from team members, senior leaders, and external stakeholders to gain diverse perspectives and insights that inform decision-making and strategy.
Adheres to all deadlines in the on-line feedback process.
If [Participant Name] were to make improvements in Feedback, what are your suggestions for how he/she can improve this?
Attitude	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Admits when wrong and demonstrates integrity in actions.
Adds creative flair or thoughtful touches to deliverables, demonstrating pride and joy in the work itself.
Engages in continuous learning, drawing lessons from both success and failure.
Pleasant and gracious to work with.
Shows empathy in their interactions with others.
If [Participant Name] were to make improvements in Attitude, what are your suggestions for how he/she can improve this?
Commitment To Result	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Takes immediate action toward goals.
Coordinates all department activities into a cohesive team effort.
Able to focus on a task even when working alone.
Encourages commitment in others to obtain results.
Conveys strong sense of own pride in Company to associates by creating a shared vision around sales and customer service.
If [Participant Name] were to make improvements in Commitment To Result, what are your suggestions for how he/she can improve this?
Recognition	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Uses both formal and informal rewards to recognize employees.
Recognizes the unique strengths, efforts, and dedication of the employee.
Uses a systematic approach to implementing recognition programs.
Uses recognition programs to help advance a specific training initiative.
Maintains appropriate documentation regarding award recipients.
If [Participant Name] were to make improvements in Recognition, what are your suggestions for how he/she can improve this?

36. Strengths
    
    
    
37. Areas for Development
    
    
    
38. Please give any final comments or suggestions for [Participant Name Here]'s assessment.