Teamwork- 360 Degree Feedback Survey Sample #5

360-Degree Assessment Survey

Dear Employee:

Thank you for participating in a 360-degree feedback assessment. In this process, you will complete a self-assessment questionnaire (below). You will also receive feedback from others including your manager, peers and direct reports. As you respond, please respond using just your experiences in the past 12 months. Rate each item using the scale shown. 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.

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

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Teamwork	Role Model	Capable and Effective	Somewhat Effective	Needs Development
I help the team make good decisions even under conditions of uncertainty.
I build strong relationships with team members.
You let team members know when they have done well.
You work cooperatively with others to solve problems.
I listen carefully to other team members.
Accountability	Role Model	Capable and Effective	Somewhat Effective	Needs Development
I ensure that employees are compensated fairly and in accordance with established policies.
I will commit to leading the initiatives to solving critical issues.
You handle sensitive information with discretion and confidentiality.
You establish performance standards for the team/department.
I review performance to determine areas for improvement.
Passion To Learn	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You enroll in continuing education courses.
You enhance your value to the company through additional training and development.
You exhibit willingness to upgrade skills through additional training and education.
You set achievable learning goals to develop new skills.
You are committed to enhancing your own knowledge and skills.
Managing Performance	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You recognize and value good performance.
I hold the team leader accountable for the team meeting key performance responsibilities.
I record production quotas on a daily basis.
I convey expectations for meeting performance metrics.
You align individual and team goals with the organization's goals and objectives.
Persuasion and Influence	Role Model	Capable and Effective	Somewhat Effective	Needs Development
I know how to win an argument.
You build trust by framing negotiations around share goals and mutual value, not just positional wins.
You work to persuade others.
You use knowledge and charisma rather than position, power, or coercion to influence others.
You champion change by framing it as an opportunity to lead, not just adapt.
Administrative Skill	Role Model	Capable and Effective	Somewhat Effective	Needs Development
I greet visitors and determine whether they should be given access to specific individuals.
You operate various telecommunications devices.
I maintain good interpersonal skills to work with supervisors, customers, colleagues, and stakeholders.
I conduct research, compile data, and prepare papers for consideration and presentation by executives, committees, and boards of directors.
I collect relevant information, such as pricing, technical details, project timelines, and past performance metrics, to include in the response.
Commitment To Result	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You convey strong sense of own pride in Company to associates by creating a shared vision around sales and customer service.
You are willing to do whatever it takes-not afraid to have to put in extra effort.
You are able to focus on a task even when working alone.
You coordinate all department activities into a cohesive team effort.
You are committed to the team.
Excellence	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You demonstrate the analytical skills to do your job.
You are planful and organized.
You demonstrate the functional or technical skills necessary to do your job.
You can be counted on to add value wherever you are involved.
You keep yourself and others focused on constant improvement.
Customer Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You received good feedback from customers.
I am competent in managing customer projects.
I make sure team members understand the issues faced by the customer.
You anticipate customer needs.
I regularly received positive feedback from customers.
Strategic Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
I maintain a strategic focus on external factors impacting the success of the company.
I create a vision for the organization based on how the organization should appear in the future.
You turn strategic priorities into action plans.
I align cross-functional teams to the strategic plan.
You effectively translate strategy into operational decisions.

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

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

    
    
52. Strengths
    
    
    
53. Areas for Development
    
    
    
54. Please give any final comments or suggestions for [Participant Name Here]'s assessment.