Teamwork- 360 Degree Feedback Survey Sample #11

360 Feedback Survey

Instructions

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 comment section for that competency. 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.

To what extent does [Participant Name] exhibit the following ...

SELECT the rating that best reflects the employee's performance in the areas listed.

Teamwork

What does Teamwork mean?
It means that ...

• You share credit for accomplishments with team members
• You make eye contact when listening to colleagues.
• You communicate well with team members.
• You are open to new ideas that may change own goals for benefit of the team
• You listen to the opinions of other team members.

To what extent does this person exhibit Teamwork?
Select from one of the ratings below.

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Initiative

What does Initiative mean?
It means that ...

• You do the right thing without being told.
• I will continue to work on a problem even in the face of obstacles.
• You immediately inform the HR Department of any personnel complaints or issues.
• I begin immediate action on projects.
• You go above and beyond the stated goals.

To what extent does this person exhibit Initiative?
Select from one of the ratings below.

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Interpersonal Skills

What does Interpersonal Skills mean?
It means that ...

• I keep commitments made with coworkers.
• You anticipate the concerns of other employees.
• I respond quickly to inquiries from potential customers.
• I take time to recognize the efforts of others.
• I am a committed and reliable partner.

To what extent does this person exhibit Interpersonal Skills?
Select from one of the ratings below.

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Emotional Intelligence

What does Emotional Intelligence mean?
It means that ...

• You are able to control your own emotions.
• You are able to manage your own emotions.
• You are able to express yourself clearly.
• You help to make decisions and solve problems using knowledge about how others will react in certain situations.
• You accurately perceive the emotional reactions of others.

To what extent does this person exhibit Emotional Intelligence?
Select from one of the ratings below.

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Global Perspective

What does Global Perspective mean?
It means that ...

• You are able to work with individuals having different backgrounds and cultures.
• You volunteer for experiences and assignments abroad.
• You consider customers point of view when making decisions.
• You are comfortable using teleconferencing equipment to facilitate meetings with others abroad.
• You communicate effectively on a multi-lingual basis.

To what extent does this person exhibit Global Perspective?
Select from one of the ratings below.

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Strengths


Areas for Development


Please give any final comments or suggestions for [Participant Name Here]'s assessment.