Results Oriented - 360 Degree Feedback Survey Sample #12

360 Feedback Survey

Instructions

We appreciate you taking the time to provide valuable feedback for the individual mentioned above. As you respond, please draw on your first-hand experience with this individual in the past 12 months. Your insights are crucial in offering a comprehensive evaluation. Please rate each item using the scale provided. If you find that you do not have sufficient first-hand knowledge to rate a particular item, select the Not Applicable option.

In addition to the ratings, we encourage you to include comments where possible. These comments are particularly useful when you give a very high or very low rating, as they provide context and clarity regarding your assessment. Explaining your reasons in the comment section helps ensure that your feedback is constructive and actionable.

Your responses, combined with feedback from other contributors, will be compiled and presented to the individual. This collective feedback aims to support their continuous growth and development by highlighting strengths and identifying areas for improvement. Your thoughtful participation is essential in helping them achieve their full potential.

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.

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Results Oriented

• Quickly analyzes the situation to determine the most pressing needs.
• Encourages a high-energy, fun work environment and coaches others on how to do the same
• Removes bureaucratic barriers to streamline processes.
• Sets priorities for tasks to be completed.
• Recognizes and rewards employees who consistently take ownership of their work.

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

Comments:

Action

• Starts immediately working on assignments.
• Pursues goals with action to achieve success.
• Takes proactive steps to address potential issues before they became a problem.
• Leverages skills and resources to exceed expectations on projects.
• Sets high standards for themselves and others.

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

Comments:

Supervisory Skills

• Maintains a calm demeanor when addressing stressful issues in the workplace.
• Provides detailed feedback to employees.
• Resolves disputes in a way that quickly reaches mutual agreement.
• Delegates assignments to employees according to seniority.
• Decides the best approach for addressing issues that arise on the job.

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

Comments:

Initiative

• Initiates actions that impact the department/company.
• Takes action without being asked.
• Immediately works to complete goals well before their deadline.
• Prepares for unexpected contingencies.
• Goes above and beyond the stated goals.

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

Comments:

Time Management

• Prioritizes high value tasks at work.
• Tackles the biggest problems at the start of the day.
• Stays undistracted by personal devices while on the clock.
• Anticipates bottlenecks and proactively redistributes time to mitigate delays.
• Prioritizes critical tasks for the beginning of the shift.

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.