Results Oriented - 360 Degree Feedback Survey Sample #9

360 Feedback Survey

Self-Assessment Instructions

Thank you for agreeing to participate in this leadership training process. As part of this process, you will be completing the self-assessment questionnaire (below). As you respond, please draw on your work experiences over the past 12 months. Rate each item using the scale shown. Comments at the end can help you to explain your ratings. If you gave 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 you at the next leadership seminar 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.

Results Oriented	Definite Strength	Meets Standards	Needs Development	N/A
You stay focused on meeting the needs of customers.
You provide clear expectations for employees.
You direct team in prioritizing daily work activities
You inspire and motivates co-workers to be productive and energetic at work
You help others when free-time is available.
Performance	Definite Strength	Meets Standards	Needs Development	N/A
You work well in this position.
You produce quality
You listen and respond to issues and problems
You are able to organize work.
You work effectively in the department.
Action	Definite Strength	Meets Standards	Needs Development	N/A
You make effective decisions
You motivate & supports others to gain skills
You drive and mobilizes others progress toward goals.
You display high energy and enthusiasm on consistent basis.
You work quickly when faced with difficult problems.
Professional Development	Definite Strength	Meets Standards	Needs Development	N/A
You demonstrate enthusiasm and a willingness to learn new skills and knowledge
You encourage employees to take courses relevant to their job.
You keep yourself up-to-date of technical/professional issues
You allow employees to fully participate in employee training and professional development.
You quickly acquire and apply new knowledge and skills when needed
Developing Others	Definite Strength	Meets Standards	Needs Development	N/A
You recognize and celebrates accomplishments of others.
You assign tasks and responsibilities to develop skills of others.
You provide constructive feedback to others.
You are open to receiving feedback.
You create a work environment that fosters positive feedback to employees.
Problem Solving	Definite Strength	Meets Standards	Needs Development	N/A
You understand the root causes of problems.
You implement effective solutions to critical problems.
You identify and assess all potential responses to a problem.
You can develop innovative solutions to problems.
You solve problems using logic and insight.
Time Management	Definite Strength	Meets Standards	Needs Development	N/A
You do not procrastinate.
You leave time in the schedule for unplanned contingencies.
You prioritize new tasks according to your relative importance.
You deal effectively with interruptions.
You make time for developing plans and schedules.
Achievement	Definite Strength	Meets Standards	Needs Development	N/A
You hold others to high standards of achievement.
You establish Specific Measurable Achievable Realistic and Timed (SMART) goals.
You establish stretch goals to advance skills and output.
You set ambitious standards of performance.
You demonstrate a well-organized and timely approach to achieve desired results
Clarity	Definite Strength	Meets Standards	Needs Development	N/A
You provide a clear vision for the future.
You make sure employees understand why they were given certain assignments.
You adjust communication methods to the needs of the audience.
You clearly explains responsibilities to individuals.
You clarify problems and your causes to help employees correct them.
Trustworthy	Definite Strength	Meets Standards	Needs Development	N/A
You are trustworthy; is someone that can be trusted.
You demonstrate congruence between statements and actions.
You work in a way that makes others want to work with you.
You deliver on promises made.
You take care to maintain confidential information.

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

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

    
    
52. Strengths
    
    
    
53. Areas for Development
    
    
    
54. Please give any final comments or suggestions for [Participant Name Here]'s assessment.