Juggling Multiple Responsibilities - 360 Degree Feedback Survey Sample #10

360 Feedback Survey

Instructions

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 comment section for that competency. 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.

Juggling Multiple Responsibilities

• Organizes tasks for the most efficient order of completion.
• Switches attention to more urgent tasks when necessary.
• Prioritizes tasks for efficiency.
• Builds in extra time in the schedule for unplanned events/occurrences.
• Completes multiple tasks simultaneously.

If [Participant Name] were to make improvements in Juggling Multiple Responsibilities, what are your suggestions for how he/she can improve this?

Punctuality

• Maintains an efficient schedule of activities.
• Arrives to meetings on time.
• Conducts appointments at scheduled start time.
• Avoids making personal phone calls during working hours.
• Starts the workday when scheduled.

If [Participant Name] were to make improvements in Punctuality, what are your suggestions for how he/she can improve this?

Continual Learning

• Seeks opportunities to grow in skills and knowledge.
• Takes the initiative to learn new skills.
• Shares best practices with others and learns from others.
• Grasps new ideas, concepts, technical, or business knowledge.
• Pursues self-improvement through continual learning.

If [Participant Name] were to make improvements in Continual Learning, what are your suggestions for how he/she can improve this?

Trustworthy

• Demonstrates a sense of responsibility and commitment to public trust.
• Is trustworthy; is someone I can trust.
• Takes ownership, delivers on commitments
• Delivers on promises made.
• Builds and maintains the trust of others.

If [Participant Name] were to make improvements in Trustworthy, what are your suggestions for how he/she can improve this?

Others

• Works across boundaries within the organization.
• Respects the opinions of other employees.
• Is able to see issues from others' perspectives.
• Constructively receives criticism and suggestions from others.
• Helpful

If [Participant Name] were to make improvements in Others, what are your suggestions for how he/she can improve this?

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

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

Strengths


Areas for Development


Please give any final comments or suggestions for [Participant Name Here]'s assessment.