Self-Management - 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.

Self Management	Definite Strength	Meets Standards	Needs Development	N/A
You do not allow own emotions to interfere with the performance of others.
You analyze own reactions on the spot to ensure that communication does not appear to be driven by anger.
You set an example for associates during stressful periods by maintaining a positive, can-do attitude.
You analyze interpersonal problems instead of reacting to them.
You step away from a situation to process appropriate response.
Continual Learning	Definite Strength	Meets Standards	Needs Development	N/A
You pursue self-improvement through continual learning.
You take charge of your training and skills enhancement.
You build on your strengths while addressing your weaknesses.
You seek opportunities to grow in skills and knowledge.
I view setbacks as opportunities to learn from.
Feedback	Definite Strength	Meets Standards	Needs Development	N/A
You consider other's opinion and suggestions.
You actively seek feedback from others.
You share past experiences with others as learning opportunities.
You are easy to approach with ideas and opinions.
You look to others for input.
Attitude	Definite Strength	Meets Standards	Needs Development	N/A
You work to eliminate unnecessary work or barriers that get in others' way.
You contribute to a positive work environment.
You contribute to a positive and fun work environment.
You build open and trusting relationships.
You show by your actions that you trust in the positive intentions of others.
Innovation	Definite Strength	Meets Standards	Needs Development	N/A
You create a safe environment for idea-sharing.
You develop new products and services.
You suggest new ideas at meetings.
You build upon the ideas and solutions of others.
You search for opportunities and innovative ways to improve the organization.
Flexibility	Definite Strength	Meets Standards	Needs Development	N/A
You are open to change and new ways of doing things.
I am able to make changes to my leadership style after receiving constructive feedback through the performance review.
You are open to the perspectives/viewpoints of others.
You are agile and versatile when dealing with issues.
I effectively manage changes in financial resources.
Bias for Action	Definite Strength	Meets Standards	Needs Development	N/A
You motivate others to achieve or exceed goals
You complete work on time
You coach others to foster an environment which can adapt quickly and willingly to rapid change.
You seek and utilize opportunities for continuous learning and self-development.
You display high energy and enthusiasm on consistent basis.
Time Management	Definite Strength	Meets Standards	Needs Development	N/A
I sustain high productivity levels throughout the day.
You focus on tasks that have high priority.
You waste very little time.
I process items in the inbox instead of letting them accumulate.
I allocate full attention to completing critical tasks.
Excellence	Definite Strength	Meets Standards	Needs Development	N/A
You produce high quality work.
You keep yourself and others focused on constant improvement.
You are planful and organized.
You demonstrate the analytical skills to do your job.
You take a lot of pride in your work.
Safety	Definite Strength	Meets Standards	Needs Development	N/A
You commit adequate resources toward safety measures.
You support our company's safety programs.
You point out behaviors in others that may be unsafe.
You ensure that all supervisors are aware of regulatory and compliance measures.
You work to implement corrective safety measures.
Teamwork	Definite Strength	Meets Standards	Needs Development	N/A
You coach team on how to solve problems, plan, and meet organizational goals and objectives.
You foster respect and understanding among team members
You support open communication between team members.
You willingly share your technical expertise
You coach team members to work toward a common goal.
Company	Definite Strength	Meets Standards	Needs Development	N/A
You understand how decisions impact other business units beyond your immediate department of work group.
You impress upon others the important aspects of [Company].
You express loyalty and dedication to [Company] in interactions with others.
You understand the "basics" as to how [Company] functions/operates.
You follow existing procedures and processes.

61. Overall, please rate the effectiveness of [Participant Name Here].
    

    5- Very Effective 4- Effective 3- Neither 2- Ineffective 1- Very Ineffective

    
    
62. Strengths
    
    
    
63. Areas for Development
    
    
    
64. Please give any final comments or suggestions for [Participant Name Here]'s assessment.