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 analyze interpersonal problems instead of reacting to them.
You use patience and self-control in working with customers and associates.
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 analyze own reactions on the spot to ensure that communication does not appear to be driven by anger.
Continual Learning	Definite Strength	Meets Standards	Needs Development	N/A
You improve on your skill sets.
You pursue learning that will enhance job performance.
You pursue self-improvement through continual learning.
You share best practices with others and learn from others.
You take charge of your training and skills enhancement.
Feedback	Definite Strength	Meets Standards	Needs Development	N/A
You ask others for their ideas and opinions.
You look to others for input.
You actively seek feedback from others.
You share past experiences with others as learning opportunities.
You accept the views of others.
Attitude	Definite Strength	Meets Standards	Needs Development	N/A
You contribute to a positive and fun work environment.
You are gracious and professional in your interactions with others.
You work to eliminate unnecessary work or barriers that get in others' way.
You treat all people fairly and with respect.
You show by your actions that you trust in the positive intentions of others.
Innovation	Definite Strength	Meets Standards	Needs Development	N/A
You build upon the ideas and solutions of others.
You challenge current procedures to develop other alternatives.
You take risks to advance important ideas.
You search for opportunities and innovative ways to improve the organization.
You encourage open communication to ensure that all proposals are considered.
Flexibility	Definite Strength	Meets Standards	Needs Development	N/A
You are effective in incorporating new ideas.
You act decisively in frequently changing and uncertain environment.
You can handle changes without complaining.
You are open to the perspectives/viewpoints of others.
You identify new opportunities to achieve goals
Bias for Action	Definite Strength	Meets Standards	Needs Development	N/A
You complete a large volume of work.
You encourage risk taking and experimentation to improve performance
You motivate others to achieve or exceed goals
You seek and utilize opportunities for continuous learning and self-development.
You complete work on time
Time Management	Definite Strength	Meets Standards	Needs Development	N/A
You keep and maintain a To-Do list.
You focus on tasks that have high priority.
You use agendas when chairing or facilitating meetings.
You complete high-priority work within required timelines.
You complete tasks ahead of schedule.
Excellence	Definite Strength	Meets Standards	Needs Development	N/A
You demonstrate the functional or technical skills necessary to do your job.
You are planful and organized.
You keep yourself and others focused on constant improvement.
You can be counted on to add value wherever you are involved.
You demonstrate the analytical skills to do your job.
Safety	Definite Strength	Meets Standards	Needs Development	N/A
You develop a culture of safety.
You seek to reduce the likelihood of accidents.
You participate in safety training when offered.
You identify and addresses safety needs.
You are committed to safety in the workplace.
Teamwork	Definite Strength	Meets Standards	Needs Development	N/A
You share credit for accomplishments with team members
You contribute to and supports team decision-making process
You are open to new ideas that may change own goals for benefit of the team
You come across as a reliable, committed team member
You build consensus and share relevant information.
Company	Definite Strength	Meets Standards	Needs Development	N/A
You express loyalty and dedication to [Company] in interactions with others.
You attend [Company] gatherings and social events.
You understand the use of [Company] products and services.
You understand how decisions impact other business units beyond your immediate department of work group.
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.