Self-Management - 360 Degree Feedback Survey Sample #10

360 Feedback Survey

Instructions

We appreciate you taking the time to provide valuable feedback for the individual mentioned above. As you respond, please draw on your first-hand experience with this individual in the past 12 months. Your insights are crucial in offering a comprehensive evaluation. Please rate each item using the scale provided. If you find that you do not have sufficient first-hand knowledge to rate a particular item, select the Not Applicable option.

In addition to the ratings, we encourage you to include comments where possible. These comments are particularly useful when you give a very high or very low rating, as they provide context and clarity regarding your assessment. Explaining your reasons in the comment section helps ensure that your feedback is constructive and actionable.

Your responses, combined with feedback from other contributors, will be compiled and presented to the individual. This collective feedback aims to support their continuous growth and development by highlighting strengths and identifying areas for improvement. Your thoughtful participation is essential in helping them achieve their full potential.

You can save your progress on partially completed forms by clicking the Save/Still Working button located at the bottom of the page. This allows you to come back at a later time to finish or make any necessary edits to the form. When you return, your previously saved responses will automatically be displayed, allowing you to seamlessly continue where you left off. When you have completed filling out the form and are confident that no further changes are needed, please click the Complete button.

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Self Management

• Does not allow own emotions to interfere with the performance of others.
• Analyzes interpersonal problems instead of reacting to them.
• Sets an example for associates during stressful periods by maintaining a positive, can-do attitude.
• Steps away from a situation to process appropriate response.
• Consciously controls own negative emotions in order to keep team morale up.

If [Participant Name] were to make improvements in Self Management, what are your suggestions for how he/she can improve this?

Creativity

• Develops solutions to challenging problems.
• Conceives, implements and evaluates ideas.
• Is creative.
• Adds value to the department/organization.
• Inspires creativity in their team.

If [Participant Name] were to make improvements in Creativity, what are your suggestions for how he/she can improve this?

Initiative

• Takes corrective action to rectify issues.
• Initiates projects that have an impact on the department.
• When working on a problem in a team, they are often the first to suggest possible solutions.
• Creates solutions to problems as soon as an incident occurs.
• Completes tasks without having to be told to do so.

If [Participant Name] were to make improvements in Initiative, what are your suggestions for how he/she can improve this?

Results Oriented

• Is a high achiever.
• Does not become distracted by non-issues or interruptions.
• Achieves long and short-term goals.
• Ensures the team understands the objective that needs to be completed.
• Stays focused on meeting the needs of customers.

If [Participant Name] were to make improvements in Results Oriented, what are your suggestions for how he/she can improve this?

Safety

• Identifies predictable hazards in the workplace.
• Participates in safety training when available.
• Supports safety programs and procedures.
• Encourages others to work safely.
• Ensures that all supervisors are aware of regulatory and compliance measures.

If [Participant Name] were to make improvements in Safety, what are your suggestions for how he/she can improve this?

Responsible

• Holds herself / himself accountable to goals / objectives
• Behavior is ethical and honest.
• ...takes personal responsibility for results.
• Completes assigned work tasks.
• Sets high personal standards of performance.

If [Participant Name] were to make improvements in Responsible, what are your suggestions for how he/she can improve this?

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

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

Strengths


Areas for Development


Please give any final comments or suggestions for [Participant Name Here]'s assessment.