Others- 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.

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Others

• Works across boundaries within the organization.
• Helpful
• Treats others with respect and dignity.
• Works effectively with people from other departments.
• Respects the opinions of other employees.

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

Comments:

Emotional Intelligence

• Helps to make decisions and solve problems using knowledge about how others will react in certain situations.
• Is able to control their own emotions.
• Is able to express themselves clearly.
• Is attentive to emotional cues and interprets others' feelings correctly.
• Helps employees to resolve conflicts, communicate clearly, and work together to solve problems.

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

Comments:

Quality

• Able to identify quality issues critical to the organization.
• Committed to the improvement of the quality of services and products.
• Adopts, integrates, and disseminates quality guidelines and standards.
• Encourages employees to produce the best quality products.
• Encourages others to produce the highest quality work products.

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

Comments:

Achievement

• Takes calculated risks.
• Takes calculated risks to achieve higher levels of performance.
• Inspires others to work with a sense of urgency.
• Strives to meet goals and objectives.
• Is determined to complete tasks regardless of obstacles that may occur.

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

Comments:

Responsible

• Holds herself / himself accountable to goals / objectives
• Behavior is ethical and honest.
• Works in a way that makes others want to work with her/him.
• Sets high personal standards of performance.
• Acts as a resource without removing individual responsibility.

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.