Performance - 360 Degree Feedback Survey Sample #5

360-Degree Assessment Survey

Dear Employee:

Thank you for participating in a 360-degree feedback assessment. In this process, you will complete a self-assessment questionnaire (below). You will also receive feedback from others including your manager, peers and direct reports. As you respond, please respond using just your experiences in the past 12 months. Rate each item using the scale shown. Comments can be very helpful; at a minimum where you give a particularly high or low rating, please share your reasons in the Closing Comments section. Your responses will be compiled with feedback from others and presented to you at the conclusion of this assessment to help guide your ongoing professional 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.

Please ensure that your submission is made by .

Thank you for your participation in the survey.

Management Team

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Performance	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You listen and respond to issues and problems
You effectively organize resources and plans
You have great overall performance
You are able to organize work.
You work effectively in the department.
Developing Others	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You encourage employees through recognition of positive changes in behavior.
You assess employees' developmental needs.
You provide constructive feedback to others.
You are open to receiving feedback.
You develop employees by offering and encouraging them to take on new or additional responsibilities.
Conflict Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
I help to maintain dignity of all persons involved.
I seek to develop a shared understanding of the issues involved.
I identify the root sources of conflict.
I address concerns about the availability of limited resources.
I persuade individuals to alter their underlying work behaviors which may have led to the conflict.
Strategic Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You reinforce the strategic messaging in various teams, meetings, seminars and workshops.
You coordinate the implementation of the strategy with stakeholders.
You exhibit a strategic orientation to identify and capitalize on opportunities to advance the organization.
You look for opportunities to enhance contributions to the bottom line.
You communicate goals and objectives to employees.
Fiscal Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You are effective in using company's resources.
You develop budgets and plans for various programs and initiatives.
You develop of the department's annual budget.
You keep excellent records for financial transparency.
You provide budgeting and accounting support to the Company.
Planning	Role Model	Capable and Effective	Somewhat Effective	Needs Development
I encourage others to follow the plan.
I can develop strategic plans for ensuring competitiveness in the marketplace.
I develop effective plans to deal with unforeseen circumstances.
You ensure that everyone in the department is onboard with the current plan.
I can create a timeline for events and monitors progress.

31. Overall, please rate the effectiveness of [Participant Name Here].
    

    5- Very Effective 4- Effective 3- Neither 2- Ineffective 1- Very Ineffective

    
    
32. Strengths
    
    
    
33. Areas for Development
    
    
    
34. Please give any final comments or suggestions for [Participant Name Here]'s assessment.