Planning- 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.

Planning

• Able to look ahead (beyond the present) when addressing the work/needs of the department.
• Anticipates obstacles and ways to overcome them.
• Makes plans and follows through.
• Works in an organized manner
• Able to identify the needs of the department before a major change.

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

Comments:

Self Management

• Uses patience and self-control in working with customers and associates.
• Consciously controls own negative emotions in order to keep team morale up.
• Does not allow own emotions to interfere with the performance of others.
• Analyzes own reactions on the spot to ensure that communication does not appear to be driven by anger.
• Is aware of personal impact on others and adjusts behavior to create a positive leadership presence.

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

Comments:

Emotional Intelligence

• Is able to control their own emotions.
• 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 express themselves clearly.

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

Comments:

Technical

• Willingly shares information and expertise; sought out as resource by others
• Keeps current with technical advances within his/her professional discipline; embraces and applies new techniques and practices
• Knows how to produce high quality products/work.
• Demonstrates mastery of the technical competencies required in his/her work.
• Willingly shares his/her technical expertise; sought out as resource by others

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.
• Works in a way that makes others want to work with her/him.
• Seeks to mitigate grievances by clarifying intentions and finding suitable remedies.
• Takes care to maintain confidential information.
• Consistently keeps commitments.

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.