Strategic Insight- 360 Degree Feedback Survey Sample #5

360-Degree Assessment Survey

Dear Employee:

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 Closing Comments section. 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.

Please ensure that your submission is made by .

Thank you for your participation in the survey.

Management Team

Strategic Insight	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Formulates policies and strategies for addressing the Company's important challenges.
Formulates strategies and action plans to ensure successful completion of goals and objectives.
Identifies potential problems before they become critical incidents.
Creates strategies that significantly benefit the Company.
Identifies root causes of problems.
Business Acumen	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Can effectively interpret and analyze market data.
Understands complex issues and problems.
Interprets data to make informed business decisions.
Can effectively interpret and analyze data.
Knows how to use financial information to make an impact on the organization.
Flexibility	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Willing to try new ideas.
Encourages others to adopt new procedures.
Open to the perspectives/viewpoints of others.
Adapts to new organizational structures, policies, or procedures.
Effective in incorporating new ideas.
Bias for Action	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Completes a large volume of work.
Encourages risk taking and experimentation to improve performance
Motivates others to achieve or exceed goals
Seeks and utilizes opportunities for continuous learning and self-development.
Displays high energy and enthusiasm on consistent basis.
Passion To Learn	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Takes advantage of training opportunities when they arise.
Enhances value to the company through additional training and development.
Will participate in training classes even if offered outside of normal working hours.
Holds self and associates accountable for goal achievement.
Is open minded and curious about learning new skills.
Leadership	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Highly effective supervisor.
Sits down regularly with employees to review their job performance.
Expresses clear goals and objectives.
Acts decisively in implementing decisions.
Motivates and challenges employees to attain a shared vision.
Results Oriented	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Directs team in prioritizing daily work activities
Inspires and motivates co-workers to be productive and energetic at work
Works toward achievement of goals even when confronted with obstacles.
Helps others when free-time is available.
Demonstrates the personal confidence to "stay the course," even when faced with difficulty
Developing Others	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Creates a work environment that fosters positive feedback to employees.
Creates opportunities for professional development.
Encourages employees through recognition of positive changes in behavior.
Tries to ensure employees are ready to move to the next level.
Sets performance objectives for subordinates that encourages development opportunities.

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

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

    
    
42. Strengths
    
    
    
43. Areas for Development
    
    
    
44. Please give any final comments or suggestions for [Participant Name Here]'s assessment.