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

Teamwork	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You provide assistance and support to other team members when needed
I help the team balance analysis with decisiveness in making decisions.
You foster an environment that promotes active listening on the team.
I facilitate effective decision-making practices to further develop the team.
You work cooperatively with others to solve problems.
Accountability	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You take ownership of problems to find the best solutions.
I take full responsibility for unmet expectations and make corrective actions immediately.
You create a consistent process for prioritizing work.
I regularly complete tasks on time.
I uphold ethical standards even when no one is watching.
Passion To Learn	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You hold self and associates accountable for goal achievement.
You take advantage of training opportunities when they arise.
You persist until goals are achieved and commitments are met.
You exhibit willingness to upgrade skills through additional training and education.
You enroll in continuing education courses.
Managing Performance	Role Model	Capable and Effective	Somewhat Effective	Needs Development
I stress the importance of meeting production quotas.
You recommend employees for distinguished service awards if warranted.
You initiate a performance improvement plan for underperforming subordinates.
You set challenging goals and objectives.
You reward employees for exceeding goals.
Persuasion and Influence	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You communicate effectively with others.
You persuade others to consider alternative points of view.
You are able to express own goals and needs.
You have excellent influencing/negotiating skills.
You attempt to persuade others rather than simply control them.
Administrative Skill	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You implement and use performance measures.
You take responsibility for decisions.
You are able to develop, justify and present a budget.
You are enthusiastic about taking on challenging projects.
You accurately implement contract provisions.
Commitment To Result	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You are able to focus on a task even when working alone.
You convey strong sense of own pride in Company to associates by creating a shared vision around sales and customer service.
You maintain persistence and dedication to achieving results.
You encourage commitment in others to obtain results.
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 keep yourself and others focused on constant improvement.
You can be counted on to add value wherever you are involved.
You are planful and organized.
You demonstrate the functional or technical skills necessary to do your job.
You demonstrate the analytical skills to do your job.
Customer Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You help customers to feel satisfied with our work/services.
You prioritize the needs and preferences of the customer.
You anticipate customer needs.
You address customer complaints immediately.
You develop strong customer relationships.
Strategic Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
I use strategic thinking to make better strategic decisions.
I develop strategies that are practical and can be feasibly implemented within a reasonable period of time.
You ensure that the department's goals are strategically aligned with the company's goals.
You coordinate the implementation of the strategy with stakeholders.
I develop a strategic plan to focus on strategic issues.

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.