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
I persist in seeking objectives despite obstacles or setbacks.
You stay focused on solving problems and getting work done.
I measure progress toward the goal.
You explain the "whys" behind organizational objectives
You keep track of progress toward the results.
Performance	Definite Strength	Meets Standards	Needs Development	N/A
You work effectively in the department.
You produce quality
You have great overall performance
You work well in this position.
You effectively organize resources and plans
Action	Definite Strength	Meets Standards	Needs Development	N/A
I am the first to volunteer for assignments.
I take responsibility for actions.
You work across organizational lines and boundaries to attain goals.
I make decisions confidently and stand by them.
You fixe problems when they occur.
Professional Development	Definite Strength	Meets Standards	Needs Development	N/A
You quickly acquire and apply new knowledge and skills when needed
You allow employees to fully participate in employee training and professional development.
You seek opportunities for professional development.
You keep yourself up-to-date of technical/professional issues
You encourage employees to take courses relevant to their job.
Developing Others	Definite Strength	Meets Standards	Needs Development	N/A
You try to ensure employees are ready to move to the next level.
You support the successes of other employees.
You recognize and celebrates accomplishments of others.
You assess employees' developmental needs.
You are open to receiving feedback.
Problem Solving	Definite Strength	Meets Standards	Needs Development	N/A
You generate alternative solutions to problems and challenges.
You work cooperatively with others to solve problems.
You solve problems using logic and insight.
You implement effective solutions to critical problems.
You can develop innovative solutions to problems.
Time Management	Definite Strength	Meets Standards	Needs Development	N/A
You integrate automation into the process whenever feasible.
You complete high-priority work within required timelines.
You set clearly defined goals.
I respond immediately to requests rather than waiting to respond.
I proactively address crucial matters.
Achievement	Definite Strength	Meets Standards	Needs Development	N/A
You take calculated risks.
You make use of talents of others to help achieve a high level of performance.
I can complete training on the new equipment.
You successfully complete the orientation training program.
You strive to meet goals and objectives.
Clarity	Definite Strength	Meets Standards	Needs Development	N/A
You avoid stating unclear or conflicting goals.
You clearly explains responsibilities to individuals.
You make sure employees understand why they were given certain assignments.
You write clear job descriptions for positions in the organization.
You adjust communication methods to the needs of the audience.
Trustworthy	Definite Strength	Meets Standards	Needs Development	N/A
You deliver on promises made.
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 seek to mitigate grievances by clarifying intentions and finding suitable remedies.

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.