Self-Management - 360 Degree Feedback Survey Sample #12

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.

To what extent does [Participant Name] exhibit the following ...

SELECT the rating that best reflects the employee's performance in the areas listed.

Self Management

• Analyzes own reactions on the spot to ensure that communication does not appear to be driven by anger.
• Sets an example for associates during stressful periods by maintaining a positive, can-do attitude.
• Is aware of personal impact on others and adjusts behavior to create a positive leadership presence.
• Analyzes interpersonal problems instead of reacting to them.
• Deals with conflict by controlling own emotions by listening, being flexible, and sincere in responding.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Emotional Intelligence

• Helps to make decisions and solve problems using knowledge about how others will react in certain situations.
• Is able to manage their own emotions.
• Accurately perceives the emotional reactions of others.
• Is able to control their own emotions.
• Is attentive to emotional cues and interprets others' feelings correctly.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Analytical

• Analyzes data and information from several sources and arrives at logical conclusions.
• Selects the appropriate techniques for analysis.
• Balances risks and costs with the rewards and probabilities of success when decisions.
• Identifies problems and issues needing resolution.
• Uses appropriate techniques to solve problems.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Goals

• Makes sure that I have a clear idea of our group's goals.
• Establishes and documents goals and objectives.
• Conducts timely follow-up; keeps others informed on a need to know basis.
• Sets high expectations and goals; encourages others to support the organization.
• Achieves established goals.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Commitment To Result

• Encourages commitment in others to obtain results.
• Coordinates all department activities into a cohesive team effort.
• Able to focus on a task even when working alone.
• Maintains persistence and dedication to achieving results.
• Creates a sense of urgency among the store team members to complete activities, which drive sales.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Strengths


Areas for Development


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