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.
• Constructively receives criticism and suggestions from others.
• ...treats others with respect and dignity.
• Respects the opinions of other employees.
• Supports the efforts of other employees in implementing solutions to problems.

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 able to express themselves clearly.
• Helps to make decisions and solve problems using knowledge about how others will react in certain situations.

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

Comments:

Quality

• Creates and implements formal guidelines for quality controls.
• Designs effective quality control systems.
• Creates quality improvement programs and processes.
• Creates a culture of excellence and high standards.
• Quickly identifies critical issues impacting quality.

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

Comments:

Achievement

• Operates with relentless drive, consistently meeting and surpassing deadlines.
• Empowers individuals through strategic planning and resource allocation to optimize outcomes.
• Completes work to a high technical standard
• Defines precise, structured objectives that helps the department progress and holds employees accountable.
• Successfully launched the ABC project.

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

Comments:

Responsible

• Is a person you can trust.
• Sets a good example.
• Behavior is ethical and honest.
• Acts as a resource without removing individual responsibility.
• Holds herself / himself accountable to goals / objectives

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.