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

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

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

Comments:

Emotional Intelligence

• Helps employees to resolve conflicts, communicate clearly, and work together to solve problems.
• Helps to make decisions and solve problems using knowledge about how others will react in certain situations.
• Is attentive to emotional cues and interprets others' feelings correctly.
• Able to understand others' points of view.
• Accurately perceives the emotional reactions of others.

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

Comments:

Analytical

• Implements data validation techniques and methods.
• Balances risks and costs with the rewards and probabilities of success when decisions.
• Uses appropriate techniques to solve problems.
• Identifies problems and issues needing resolution.
• Identifies the root cause of a problem.

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

Comments:

Goals

• Sets high expectations and goals; encourages others to support the organization.
• Achieves goals.
• Achieves established goals.
• Understands & contributes to development of strategic goals.
• Conducts timely follow-up; keeps others informed on a need to know basis.

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

Comments:

Commitment To Result

• Able to focus on a task even when working alone.
• Maintains persistence and dedication to achieving results.
• Willing to do whatever it takes-not afraid to have to put in extra effort.
• Committed to the team.
• Conveys strong sense of own pride in Company to associates by creating a shared vision around sales and customer service.

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.