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

• Consistently demonstrates ability and willingness to trust others.
• Supports the efforts of other employees in implementing solutions to problems.
• ...treats others with respect and dignity.
• Constructively receives criticism and suggestions from others.
• Helpful

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

Comments:

Emotional Intelligence

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

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

Comments:

Quality

• Corrects issues in a timely manner.
• Encourages employees to produce the best quality products.
• Analyze what occurred and re-adjusts accordingly when goals are not met.
• Encourages others to produce the highest quality work products.
• Holds employees accountable for their quality of work.

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

Comments:

Achievement

• Demonstrates a well-organized and timely approach to achieve desired results
• Is determined to complete tasks regardless of obstacles that may occur.
• Eliminates bureaucratic barriers to streamline processes.
• Completed required training and certification.
• Demonstrates a sense of urgency to quickly and accurately solve problems and issues.

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

Comments:

Responsible

• ...takes personal responsibility for results.
• Responsible for setting the vision of the department.
• Sets high personal standards of performance.
• Completes assigned work tasks.
• 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.