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

• Does not become distracted by non-issues or interruptions.
• Encourages a high-energy, fun work environment and coaches others on how to do the same
• Stays focused on meeting the needs of customers.
• Directs team in prioritizing daily work activities
• Demonstrates the personal confidence to "stay the course," even when faced with difficulty

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

Comments:

Action

• Gets the job done.
• Is not afraid to take corrective action when necessary.
• Drives and mobilizes others progress toward goals.
• Works quickly when faced with difficult problems.
• Makes effective decisions, even when under pressure.

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

Comments:

Supervisory Skills

• Determines the training and development needs of employees and staff.
• Effective in resolving conflicts to mutual satisfaction of the parties.
• Facilitates team members working well together.
• Has a strong work ethic that inspires others.
• Offers non-monetary rewards as incentives for employees.

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

Comments:

Initiative

• Acts with urgency when time is of the essence.
• Will continue to work on a problem even in the face of obstacles.
• Takes the initiative to solve pressing issues.
• Confronts problems immediately without supervisor instructions.
• Takes action to implement new changes in the policies and procedures.

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

Comments:

Time Management

• Does not procrastinate.
• Sets a good balance between work and family life.
• Keeps and maintains a To-Do list.
• Avoids distractions in the workplace.
• Prioritizes new tasks according to their relative importance.

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.