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

• Produces a high volume of work.
• Determines the objectives for the project.
• Quickly analyzes the situation to determine the most pressing needs.
• Works toward achievement of goals even when confronted with obstacles.
• Ensures the team understands the objective that needs to be completed.

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

Comments:

Action

• Converts plans into actions.
• Moves forward on important projects.
• Works across organizational lines and boundaries to attain goals.
• Encourages and supports a culture of excellence and continuous improvement within the department.
• Takes action in critical situations.

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

Comments:

Supervisory Skills

• Maintains good working relationships with employees.
• Provides constructive, ongoing feedback.
• Maintains disciplinary policy and fair enforcement of work rules
• Conducts regular performance management sessions.
• Others emulate this supervisor's enthusiasm for work.

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

Comments:

Initiative

• Begins immediate action on projects.
• Gladly seeks additional responsibilities.
• Builds strong interpersonal relationships upon first meeting.
• Seizes upon chances to improve the department's prospects.
• Confronts problems immediately without supervisor instructions.

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

Comments:

Time Management

• Regularly delivers results on-time.
• Understands the importance of being on time.
• Allocates time to the highest priority items.
• Records time spent on work and non-work related items.
• Is proactive in addressing important issues.

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.