Juggling Multiple Responsibilities - 360 Degree Feedback Survey Sample #11

360 Feedback Survey

Instructions

We appreciate you taking the time to provide valuable feedback for the individual mentioned above. As you respond, please draw on your first-hand experience with this individual in the past 12 months. Your insights are crucial in offering a comprehensive evaluation. Please rate each item using the scale provided. If you find that you do not have sufficient first-hand knowledge to rate a particular item, select the Not Applicable option.

In addition to the ratings, we encourage you to include comments where possible. These comments are particularly useful when you give a very high or very low rating, as they provide context and clarity regarding your assessment. Explaining your reasons in the comment section helps ensure that your feedback is constructive and actionable.

Your responses, combined with feedback from other contributors, will be compiled and presented to the individual. This collective feedback aims to support their continuous growth and development by highlighting strengths and identifying areas for improvement. Your thoughtful participation is essential in helping them achieve their full potential.

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.

To what extent does [Participant Name] exhibit the following ...

SELECT the rating that best reflects the employee's performance in the areas listed.

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Juggling Multiple Responsibilities

What does Juggling Multiple Responsibilities mean?
It means that ...

• You use a scheduler/planner to keep tasks organized and on time.
• You prioritize tasks for efficiency.
• You switch attention to more urgent tasks when necessary.
• You rank the importance of tasks to make sure critical tasks are completed first.
• You assign tasks based on skills of team members.

To what extent does this person exhibit Juggling Multiple Responsibilities?
Select from one of the ratings below.

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Initiative

What does Initiative mean?
It means that ...

• You volunteer your time and effort toward the completion of important goals.
• I seek alternative methods or resources when initial approaches fail or are unavailable.
• You immediately inform the HR Department of any personnel complaints or issues.
• I take on additional tasks without being asked or told to do so.
• I anticipate problems and initiate plans to address them.

To what extent does this person exhibit Initiative?
Select from one of the ratings below.

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Excellence

What does Excellence mean?
It means that ...

• You are planful and organized.
• You keep yourself and others focused on constant improvement.
• You produce high quality work.
• You demonstrate the analytical skills to do your job.
• You demonstrate the functional or technical skills necessary to do your job.

To what extent does this person exhibit Excellence?
Select from one of the ratings below.

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Teamwork

What does Teamwork mean?
It means that ...

• You seek and listen to other's contributions
• You show respect for other team members.
• I am able to work closely other team members who are considered to be difficult to work with.
• You promote open communication on the team.
• I am willing to listen to the ideas of other team members.

To what extent does this person exhibit Teamwork?
Select from one of the ratings below.

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Supervisory Skills

What does Supervisory Skills mean?
It means that ...

• I maintain disciplinary policies and fair enforcement of work rules
• You use persuasion rather than threats of disciplinary action.
• I am successful in resolving personnel conflicts.
• You identify and maximize opportunities for continuing education for employees.
• I recognize when employees have completed major milestones.

To what extent does this person exhibit Supervisory Skills?
Select from one of the ratings below.

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Strengths


Areas for Development


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