Self-Management - 360 Degree Feedback Survey Sample #10

360 Feedback Survey

Instructions

Thank you for providing feedback for the recipient above. As you respond, please draw on your first-hand experience with this individual in the past 12 months. Rate each item using the scale shown. If you don't feel you have enough first-hand information to rate a certain item, please choose the Not Applicable option. Comments can be very helpful; at a minimum where you give 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 the recipient to help guide their ongoing 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

• Analyzes interpersonal problems instead of reacting to them.
• Uses patience and self-control in working with customers and associates.
• Steps away from a situation to process appropriate response.
• Consciously controls own negative emotions in order to keep team morale up.
• Is aware of personal impact on others and adjusts behavior to create a positive leadership presence.

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

Creativity

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

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

Initiative

• Coach others to foster an environment which can adapt quickly and willingly to rapid change.
• Prepares for unexpected contingencies.
• Goes above and beyond the stated goals.
• Immediately works to complete goals well before their deadline.
• Seeks and utilizes opportunities for continuous learning and self-development.

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

Results Oriented

• Stays focused on meeting the needs of customers.
• Provides clear expectations for employees.
• Directs team in prioritizing daily work activities
• Encourages a high-energy, fun work environment and coaches others on how to do the same
• Demonstrates the personal confidence to "stay the course," even when faced with difficulty

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

Safety

• Participates in safety training when available.
• Is aware of OSHA safety guidelines.
• Is not afraid to question a potential safety issue observed in the workplace.
• Ensures that all supervisors are aware of regulatory and compliance measures.
• Identifies and addresses safety needs.

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

Responsible

• Acts as a resource without removing individual responsibility.
• Is a person you can trust.
• Works in a way that makes others want to work with her/him.
• ...takes personal responsibility for results.
• Sets a good example.

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.