Results Oriented - 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.

Results Oriented

• Inspires and motivates co-workers to be productive and energetic at work
• Directs team in prioritizing daily work activities
• Explains the "whys" behind organizational objectives
• Works toward achievement of goals even when confronted with obstacles.
• Does not become distracted by non-issues or interruptions.

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

Comments:

Action

• Works quickly when faced with difficult problems.
• Makes effective decisions, even when under pressure.
• Is not afraid to take corrective action when necessary.
• Effectively makes decisions
• Does whatever it takes (within reason) to get the job done.

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

Comments:

Supervisory Skills

• Delegates effectively.
• Is aware of the unique strengths of each employee.
• Promotes teamwork and cooperation within the department.
• Provides constructive, ongoing feedback.
• Maintains good working relationships with employees.

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

Comments:

Initiative

• Coach others to foster an environment which can adapt quickly and willingly to rapid change.
• Takes action without being asked.
• Immediately works to complete goals well before their deadline.
• Takes the initiative to change the direction or course of events.
• 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 new tasks according to their relative importance.
• Focuses on tasks that have high priority.
• Does not become flustered by deadlines and timelines.
• Uses agendas when chairing or facilitating meetings.
• Does not procrastinate.

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.