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.

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Thank you for your participation in the survey.

Management Team

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Teamwork	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You work cooperatively with others to solve problems.
You support open communication between team members.
I consider the impact and implications of decisions on the team.
I establish good rapport with team members.
You encourage dialog between team members.
Accountability	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You take full responsibility for project outcomes.
You hold employees accountable through regular performance reviews.
You do not make excuses for missed deadlines.
You take responsibility for seeing the project through to completion.
You take responsibility for the direction of the team.
Passion To Learn	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You persist until goals are achieved and commitments are met.
You recognize own areas for development and consciously seek assignments that will provide practice in areas of developmental need.
You keep up-to-date with your skills.
You exhibit willingness to upgrade skills through additional training and education.
You see feedback from others as an opportunity to learn and advance professionally.
Managing Performance	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You create several measures of success for each goal.
You set clear and ambitious goals to be met.
You ensure employees are accountable for meeting OKRs.
You measure job performance of subordinates against defined goals and objectives.
I convey expectations for meeting performance metrics.
Persuasion and Influence	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You seek to obtain consensus or compromise.
You develop a good rapport with others.
You persuade others to consider alternative points of view.
You understand what others need.
You communicate effectively with others.
Administrative Skill	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You have strong organizational skills to keep the workspace and department in order
You have a high attention to detail.
You are enthusiastic about taking on challenging projects.
You have strong technical/computer skills.
You accurately implement contract provisions.
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 committed to the team.
You encourage commitment in others to obtain results.
You coordinate all department activities into a cohesive team effort.
You create a sense of urgency among the store team members to complete activities, which drive sales.
Excellence	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You are planful and organized.
You produce high quality work.
You demonstrate the analytical skills to do your job.
You demonstrate the functional or technical skills necessary to do your job.
You take a lot of pride in your work.
Customer Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
I make sure team members understand the issues faced by the customer.
You use feedback from customers to help improve services.
You anticipate potential obstacles to meeting customer needs.
I tailor solutions to meet the specific needs of each customer.
You create customized solutions for the customer.
Strategic Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
I am effective in using strategic tools such as value chain analysis, business environment analysis, and competitor analysis.
You focus efforts on specific marketing strategies.
You create a SWOT matrix to help analyze data.
I develop a strategic vision for the future.
You strategically deploy resources to areas of the greatest need.

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.