Leadership - 360 Degree Feedback Survey Sample #12

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.

Leadership

• Able to organize the work of others.
• Motivates and challenges employees to attain a shared vision.
• Acts decisively in implementing decisions.
• Guides decision-making by coaching, counseling and rewarding.
• Able to influence others.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Establishing Focus/Direction

• Maintains self-control when personally criticized.
• Helps guide employees with prioritizing tasks.
• Excellent at managing time.
• Maintains focus when handling several problems or tasks simultaneously.
• Stays focused even when under pressure and stress.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Persuasion and Influence

• Able to express own goals and needs.
• Persuades others to consider alternative points of view.
• Has excellent influencing/negotiating skills.
• Understanding what others need.
• Communicates effectively with others.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Safety

• Identifies predictable hazards in the workplace.
• Is not afraid to question a potential safety issue observed in the workplace.
• Develops a sustainable safety culture.
• Performs work safely.
• Supports safety programs and procedures.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Global Perspective

• Accepts setbacks and challenges in foreign markets as improvement opportunities
• Able to work with others from different cultures and countries.
• Analyzes global issues/problems that are having a large impact on the Company.
• Respects individual differences.
• Has positive interactions with individuals from different cultures and backgrounds.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Strengths


Areas for Development


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