Teamwork- 360 Degree Feedback Survey Sample #12

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

• Coaches team members
• Fosters teamwork rather than individual competition
• Act as an effective team player
• Comes across as a reliable, committed team member
• Encourages collaboration with other departments.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Performance

• Able to organize work.
• ...Overall Performance
• Effective in performing his/her job.
• Works well in this position.
• Works effectively in the department.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Results Oriented

• Provides clear expectations for employees.
• Encourages a high-energy, fun work environment and coaches others on how to do the same
• Directs team in prioritizing daily work activities
• Stays focused on meeting the needs of customers.
• Demonstrates the personal confidence to "stay the course," even when faced with difficulty

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Safety

• Encourages others to work safely.
• Is not afraid to question a potential safety issue observed in the workplace.
• Keeps accurate safety records.
• Participates in safety training when offered.
• Develops a strong safety culture.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Entrepreneurship

• Devotes a certain amount of time and effort to developing new business opportunities.
• Encourages dynamic growth opportunities.
• Exhibits determination and passion in completion of goals.
• Excellent at managing relationships with stakeholders.
• Finds unique ways to go around barriers to success.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Strengths


Areas for Development


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