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 encourage a high-energy, fun work environment and coaches others on how to do the same
You demonstrate the personal confidence to "stay the course," even when faced with difficulty
You direct team in prioritizing daily work activities
You inspire and motivates co-workers to be productive and energetic at work
You provide clear expectations for employees.
Performance	Definite Strength	Meets Standards	Needs Development	N/A
You are effective in performing your job.
You produce quality
You work effectively in the department.
You set a high standard for job performance.
You work well in this position.
Action	Definite Strength	Meets Standards	Needs Development	N/A
You display high energy and enthusiasm on consistent basis.
You drive and mobilizes others progress toward goals.
You motivate & supports others to gain skills
You make effective decisions, even when under pressure.
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 seek opportunities for professional development.
You allow employees to fully participate in employee training and professional development.
You are contributing fully to the extent of your skills
Developing Others	Definite Strength	Meets Standards	Needs Development	N/A
You set performance objectives for subordinates that encourages development opportunities.
You create opportunities for professional development.
You assess employees' developmental needs.
You try to ensure employees are ready to move to the next level.
You are open to receiving feedback.
Problem Solving	Definite Strength	Meets Standards	Needs Development	N/A
You can develop innovative solutions to problems.
You work cooperatively with others to solve problems.
You actively seek the root cause of a problem.
You generate alternative solutions to problems and challenges.
You find creative ways to get things done with limited resources.
Time Management	Definite Strength	Meets Standards	Needs Development	N/A
You use agendas when chairing or facilitating meetings.
You avoid distractions in the workplace.
You make time for developing plans and schedules.
You deal effectively with interruptions.
You complete tasks ahead of schedule.
Achievement	Definite Strength	Meets Standards	Needs Development	N/A
You hold others to high standards of achievement.
You inspire others to work with a sense of urgency.
You set high standards in your performance
You are determined to complete tasks regardless of obstacles that may occur.
You work at a quick pace to complete a high volume of work.
Clarity	Definite Strength	Meets Standards	Needs Development	N/A
You check details thoroughly.
You make sure employees understand why they were given certain assignments.
You attend to the important details of a job or task.
You use appropriate grammar and tense in communications.
You avoid stating unclear or conflicting goals.
Trustworthy	Definite Strength	Meets Standards	Needs Development	N/A
You take ownership, deliver on commitments
You demonstrate congruence between statements and actions.
You work in a way that makes others want to work with you.
You take care to maintain confidential information.
You consistently keep commitments.

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.