Responsibility - 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.

Responsible

• Sets high personal standards of performance.
• Behavior is ethical and honest.
• Works in a way that makes others want to work with her/him.
• ...takes personal responsibility for results.
• Responsible for setting the vision of the department.

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

Comments:

Management

• Makes you feel enthusiastic about your work
• Keep staff informed about what is happening in the company
• Is ready to offer help
• Delegate tasks effectively
• Takes responsibility for things that go wrong

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

Comments:

Innovation

• Suggests new ideas at meetings.
• Encourages open communication to ensure that all proposals are considered.
• Offers constructive improvements to existing systems.
• Analyzes current procedures and identifies opportunities for improvement.
• Searches for opportunities and innovative ways to improve the organization.

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

Comments:

Technology Use/Management

• Uses technology in decision making and problem solving.
• Proficient in the use of technical systems and processes.
• Applies complex rules and regulations to maintain optimal system performance.
• Maximizes the use of new technology to deliver products and services.
• Supports employee training and development initiatives regarding implementation of technology.

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

Comments:

Company

• Follows existing procedures and processes.
• Impresses upon others the important aspects of [Company].
• Attends [Company] gatherings and social events.
• Understands the use of [Company] products and services.
• Expresses loyalty and dedication to [Company] in interactions with others.

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.