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.

Others

• Helpful
• Works effectively with people from other departments.
• Supports the efforts of other employees in implementing solutions to problems.
• Able to see issues from others' perspectives.
• Forms working relationships with employees from other departments.

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

Comments:

Emotional Intelligence

• Is able to manage their own emotions.
• Helps employees to resolve conflicts, communicate clearly, and work together to solve problems.
• Able to understand others' points of view.
• Is able to control their own emotions.
• Is attentive to emotional cues and interprets others' feelings correctly.

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

Comments:

Quality

• Committed to the improvement of the quality of services and products.
• Understands and uses established quality procedures/controls.
• Proposes a variety of solutions to address quality needs.
• Develops measures of the success of quality initiatives.
• Addresses barriers to successfully implementing quality standards.

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

Comments:

Achievement

• Sets challenging goals.
• Takes calculated risks to achieve difficult goals.
• Sets challenging goals for the department.
• Makes a plan for getting things done and drives execution of the strategic plan, actively supporting or leading initiatives to closure.
• Increased production by 20 percent.

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

Comments:

Responsible

• Sets high personal standards of performance.
• Sets a good example
• Behavior is ethical and honest.
• Is a person you can trust.
• ...takes personal responsibility for results.

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.