Self-Management - 360 Degree Feedback Survey Sample #12

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.

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.

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Self Management

• Consciously controls own negative emotions in order to keep team morale up.
• Sets an example for associates during stressful periods by maintaining a positive, can-do attitude.
• Analyzes own reactions on the spot to ensure that communication does not appear to be driven by anger.
• Uses patience and self-control in working with customers and associates.
• Does not allow own emotions to interfere with the performance of others.

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

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

Comments:

Analytical

• Proves hypotheses and theories using data and experiments.
• Gathers information from a variety of sources.
• Able to interpret and analyze data.
• Identifies the root cause of a problem.
• Is precise in the measurement of variables, leading to more accurate data collection.

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

Comments:

Goals

• Defines clear and specific goals.
• Effectively manages the pursuit of multiple goals at the same time by skillfully balancing priorities, resources, and time.
• Establishes and documents goals and objectives.
• Maintains focus and avoids disruptions to achieve goals.
• Serves as a committed partner to significantly enhance the probability of achieving objectives.

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

Comments:

Commitment

• Keeps priorities clear, resisting distractions and staying aligned with agreed-upon commitments.
• Has personal values that are aligned with organizational values.
• Mobilizes individual commitment for the new initiatives.
• Sets non-negotiable benchmarks, making clear that certain standards and commitments cannot be compromised.
• Stays focused on the task.

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.