Planning- 360 Degree Feedback Survey Sample #12





360 Feedback Survey

Assessments Measuring Planning:
Survey 1 (4-point scale; Competency Comments)
Survey 2 (4-point scale; Competency Comments)
Survey 3 (5-point scale; Competency Comments)
Survey 4 (5-point scale; radio buttons)
Survey 5 (4-point scale; words)
Survey 6 (4-point scale; words)
Survey 7 (5-point scale; competency comments; N/A)
Survey 8 (3-point scale; Agree/Disagree words; N/A)
Survey 9 (3-point scale; Strength/Development; N/A)
Survey 10 (Comment boxes only)
Survey 11 (Single rating per competency)
Survey 12 (Slide-bar scale)
Survey 13 (4-point scale; numbers; floating anchors)
Survey 14 (4-point scale; N/A)
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.

Sample Result Document:
Sample Results
To what extent does [Participant Name] exhibit the following ...

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


Planning

  • Anticipates resources needed to successfully implement a plan or project.
  • Efficiently manages deadlines.
  • Is able to follow the plan set in place.
  • Plans for future staffing needs.
  • Establishes a course of action for self and others to accomplish specific goals.
Needs
Improvement
Fully
Proficient
Excels/
Role Model






Click this box to make your rating
Comments:

Self Management

  • Steps away from a situation to process appropriate response.
  • Is aware of personal impact on others and adjusts behavior to create a positive leadership presence.
  • Consciously controls own negative emotions in order to keep team morale up.
  • Analyzes own reactions on the spot to ensure that communication does not appear to be driven by anger.
  • Does not allow own emotions to interfere with the performance of others.
Needs
Improvement
Fully
Proficient
Excels/
Role Model






Click this box to make your rating
Comments:

Emotional Intelligence

  • Helps employees to resolve conflicts, communicate clearly, and work together to solve problems.
  • Is able to manage their own emotions.
  • Able to understand others' points of view.
  • Accurately perceives the emotional reactions of others.
  • Is able to express themselves clearly.
Needs
Improvement
Fully
Proficient
Excels/
Role Model






Click this box to make your rating
Comments:

Technical

  • Is naturally sought out by people outside his/her particular area for advice and opinion on a broad range of matters - not necessarily solely legal advice.
  • Willingly shares his/her technical expertise; sought out as resource by others
  • Uses expertise to identify issues and think through creative solutions to get a problem solved or objective accomplished.
  • Keeps current with technical advances within his/her professional discipline; embraces and applies new techniques and practices
  • Is knowledgeable of procedures or systems necessary for the job.
Needs
Improvement
Fully
Proficient
Excels/
Role Model






Click this box to make your rating
Comments:

Trustworthy

  • Communicates an understanding of the other person's interests, needs and concerns.
  • Demonstrates a sense of responsibility and commitment to public trust.
  • Takes care to maintain confidential information.
  • Takes ownership, delivers on commitments
  • Is a person you can trust.
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.