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 are aware of personal impact on others and adjusts behavior to create a positive leadership presence.
You consciously control own negative emotions in order to keep team morale up.
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.
You step away from a situation to process appropriate response.
Continual Learning	Definite Strength	Meets Standards	Needs Development	N/A
You build on your strengths while addressing your weaknesses.
You improve on your skill sets.
You pursue professional development opportunities when they arise.
You pursue learning that will enhance job performance.
You participate in regular training offered.
Feedback	Definite Strength	Meets Standards	Needs Development	N/A
You consider other's opinion and suggestions.
You are easy to approach with ideas and opinions.
You seek feedback to enhance performance.
You ask others for their ideas and opinions.
You actively seek feedback from others.
Attitude	Definite Strength	Meets Standards	Needs Development	N/A
You contribute to a positive work environment.
You show by your actions that you trust in the positive intentions of others.
You build open and trusting relationships.
You work to eliminate unnecessary work or barriers that get in others' way.
You are gracious and professional in your interactions with others.
Innovation	Definite Strength	Meets Standards	Needs Development	N/A
You encourage open communication to ensure that all proposals are considered.
You search for opportunities and innovative ways to improve the organization.
You build upon the ideas and solutions of others.
You challenge current procedures to develop other alternatives.
You find creative ways to get things done with limited resources.
Flexibility	Definite Strength	Meets Standards	Needs Development	N/A
You identify new opportunities to achieve goals
You work effectively during periods of change.
You act decisively in frequently changing and uncertain environment.
You can handle changes without complaining.
You are open to the perspectives/viewpoints of others.
Bias for Action	Definite Strength	Meets Standards	Needs Development	N/A
You seek and utilize opportunities for continuous learning and self-development.
You convey a sense of urgency about addressing problems and opportunities
You identify ways to simplify work processes and reduce cycle times
You complete work on time
You motivate others to achieve or exceed goals
Time Management	Definite Strength	Meets Standards	Needs Development	N/A
You use agendas when chairing or facilitating meetings.
You focus on tasks that have high priority.
You set a good balance between work and family life.
You set clearly defined goals.
You keep and maintain a To-Do list.
Excellence	Definite Strength	Meets Standards	Needs Development	N/A
You demonstrate the functional or technical skills necessary to do your job.
You produce high quality work.
You are planful and organized.
You keep yourself and others focused on constant improvement.
You take a lot of pride in your work.
Safety	Definite Strength	Meets Standards	Needs Development	N/A
You perform work safely.
You create accurate and effective measures of safety.
You encourage others to attend safety training.
You develop a strong safety culture.
You participate in safety training when available.
Teamwork	Definite Strength	Meets Standards	Needs Development	N/A
You encourage others to share ideas to develop team cohesion
You encourage collaboration with other departments.
You willingly share your technical expertise
You are an effective team player
You provide assistance and support to other team members when needed
Company	Definite Strength	Meets Standards	Needs Development	N/A
You follow existing procedures and processes.
You attend [Company] gatherings and social events.
You express loyalty and dedication to [Company] in interactions with others.
You understand the "basics" as to how [Company] functions/operates.
You impress upon others the important aspects of [Company].

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.