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 deal with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
You step away from a situation to process appropriate response.
You set an example for associates during stressful periods by maintaining a positive, can-do attitude.
You use patience and self-control in working with customers and associates.
You do not allow own emotions to interfere with the performance of others.
Continual Learning	Definite Strength	Meets Standards	Needs Development	N/A
You pursue professional development opportunities when they arise.
You seek opportunities to grow in skills and knowledge.
You participate in regular training offered.
You pursue learning that will enhance job performance.
You take charge of your training and skills enhancement.
Feedback	Definite Strength	Meets Standards	Needs Development	N/A
You are open to the suggestions of others.
You seek feedback to enhance performance.
You are easy to approach with ideas and opinions.
You consider other's opinion and suggestions.
You ask others for their ideas and opinions.
Attitude	Definite Strength	Meets Standards	Needs Development	N/A
You build open and trusting relationships.
You contribute to a positive and fun work environment.
You visibly support and encourages diversity in style and background.
You work to eliminate unnecessary work or barriers that get in others' way.
You show by your actions that you trust in the positive intentions of others.
Innovation	Definite Strength	Meets Standards	Needs Development	N/A
You offer constructive improvements to existing systems.
You encourage open communication to ensure that all proposals are considered.
You take risks to advance important ideas.
You create improved methods or solutions for meeting goals and objectives.
You suggest new ideas at meetings.
Flexibility	Definite Strength	Meets Standards	Needs Development	N/A
You are willing to try new ideas.
You adapt to new organizational structures, policies, or procedures.
You can handle changes without complaining.
You work effectively during periods of change.
You are able to adapt to new situations.
Bias for Action	Definite Strength	Meets Standards	Needs Development	N/A
You coach others to foster an environment which can adapt quickly and willingly to rapid change.
You complete a large volume of work.
You display high energy and enthusiasm on consistent basis.
You project a "can-do" attitude when interfacing with peers, subordinates and customers(especially during difficult and challenging times).
You convey a sense of urgency about addressing problems and opportunities
Time Management	Definite Strength	Meets Standards	Needs Development	N/A
You act promptly without delay.
You encourage colleagues to spend more time on work related activities.
You set time limits on how much time is spent on particular tasks so that one task does not dominate the schedule.
I prioritize critical tasks for the beginning of the shift.
I consistently meet production deadlines.
Excellence	Definite Strength	Meets Standards	Needs Development	N/A
You demonstrate the analytical skills to do your job.
You demonstrate the functional or technical skills necessary to do your job.
You can be counted on to add value wherever you are involved.
You produce high quality work.
You take a lot of pride in your work.
Safety	Definite Strength	Meets Standards	Needs Development	N/A
You identify predictable hazards in the workplace.
You support our company's safety programs.
You develop a sustainable safety culture.
You perform work safely.
You participate in safety training as applicable.
Teamwork	Definite Strength	Meets Standards	Needs Development	N/A
I facilitate good rapport between team members.
I help the team bounce back from obstacles to progress.
You actively participates in the work of teams; seek and listen to others' contributions
I make sure each team member participates in the task.
You give constructive advice to other team members.
Company	Definite Strength	Meets Standards	Needs Development	N/A
You attend [Company] gatherings and social events.
You impress upon others the important aspects of [Company].
You understand how decisions impact other business units beyond your immediate department of work group.
You express loyalty and dedication to [Company] in interactions with others.
You understand the "basics" as to how [Company] functions/operates.

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.