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
I consistently complete tasks on time and meet commitments without reminders.
You approach problems with curiosity rather than frustration.
I sustain performance by anticipating and mitigating obstacles.
I demonstrate determination and follow-through despite competing demands.
You set goals that stretch performance while maintaining quality standards.
Developing Others	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You are open to receiving feedback.
You recognize and celebrates accomplishments of others.
You set performance objectives for subordinates that encourages development opportunities.
You assign tasks and responsibilities to develop skills of others.
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 use conflict as a springboard for leadership development, help individuals grow in resilience, empathy, and influence.
You are able to settle disputes equitably.
You craft messages that resonate better with the parties involved, making it easier to convey concerns and perspectives in a constructive manner.
I reduce ambiguity that often leads to conflict by proactively defining roles, responsibilities, and communication norms.
I use data or evidence strategically to support resolution strategies and influence skeptical stakeholders.
Strategic Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You focus efforts on specific marketing strategies.
I pursue strategic alliances with valued partners.
I mobilize change through executive leadership to implement corporate strategies.
I create innovative strategies.
Yoy scan both the internal and external environment to identify strategic opportunities to improve the organization.
Fiscal Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You develop budgets and plans for various programs and initiatives.
You develop of the department's annual budget.
You effectively manage appropriations, reporting, purchases, expenditures, payrolls, and staff.
You monitor spending.
You provide budgeting and accounting support to the Company.
Planning	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You notify staff when the plan is not on schedule.
I determine what supplies/equipment will be needed for the job.
You create to-do lists to make sure nothing is missed.
You establish and monitor timeframes and timelines.
You understand what materials will be required to successfully implement the plan.

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.