Teamwork- 360 Degree Feedback Survey Sample #12

360 Feedback Survey

Instructions

We appreciate you taking the time to provide valuable feedback for the individual mentioned above. As you respond, please draw on your first-hand experience with this individual in the past 12 months. Your insights are crucial in offering a comprehensive evaluation. Please rate each item using the scale provided. If you find that you do not have sufficient first-hand knowledge to rate a particular item, select the Not Applicable option.

In addition to the ratings, we encourage you to include comments where possible. These comments are particularly useful when you give a very high or very low rating, as they provide context and clarity regarding your assessment. Explaining your reasons in the comment section helps ensure that your feedback is constructive and actionable.

Your responses, combined with feedback from other contributors, will be compiled and presented to the individual. This collective feedback aims to support their continuous growth and development by highlighting strengths and identifying areas for improvement. Your thoughtful participation is essential in helping them achieve their full potential.

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

• Helps the team decide what long term goals need to be met.
• Works cooperatively with others to solve problems.
• Works with other team members to achieve objectives.
• Appreciates the input from other team members.
• Builds a strong rapport with team members.

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

Comments:

Performance

• Has great overall performance
• Shown significant improvement in job performance.
• Works well in this position.
• Effective in performing his/her job.
• Sets a high standard for job performance.

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

Comments:

Results Oriented

• Views obstacles as opportunities to improve self.
• Has a work ethic with a strong desire to obtain results.
• Holds self and others accountable for achieving results.
• Produces a high volume of work.
• Focuses on achieving important goals.

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

Comments:

Safety

• Develops a culture of safety.
• Participates in safety training as applicable.
• Encourages others to attend safety training.
• Committed to safety in the workplace.
• Works to implement corrective safety measures.

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

Comments:

Entrepreneurship

• Seeks and utilizes mentors to help guide professional development.
• Encourages risk taking for developing potential business opportunities.
• Is comfortable operating in an environment of uncertainty.
• Finds unique ways to go around barriers to success.
• Devotes a certain amount of time and effort to developing new business opportunities.

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.