Others- 360 Degree Feedback Survey Sample #12

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.

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

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

Others

• Supports the efforts of other employees in implementing solutions to problems.
• Respects the opinions of other employees.
• Is able to see issues from others' perspectives.
• Helpful
• Constructively receives criticism and suggestions from others.

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

Comments:

Emotional Intelligence

• Accurately perceives the emotional reactions of others.
• Is able to control their own emotions.
• Helps to make decisions and solve problems using knowledge about how others will react in certain situations.
• Able to understand others' points of view.
• Is able to express themselves clearly.

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

Comments:

Quality

• Corrects issues in a timely manner.
• Encourages others to produce the highest quality work products.
• Reflects on what is working and what could be improved.
• Encourages others to achieve high quality standards.
• Always strives to produce the highest quality work products.

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

Comments:

Achievement

• Makes a plan for getting things done and drives execution of the strategic plan, actively supporting or leading initiatives to closure.
• Accepts setbacks and challenges as improvement opportunities
• Schedules time for self and others to optimize high priority and long term actions. Monitors progress towards business goals.
• Set high standards in their performance
• Demonstrates a well-organized and timely approach to achieve desired results

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

Comments:

Responsible

• Sets a good example.
• Behavior is ethical and honest.
• ...takes personal responsibility for results.
• Is a person you can trust.
• Works in a way that makes others want to work with her/him.

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.