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

• Willingly share their technical expertise
• Relates to all kinds of people tactfully
• Actively and openly participates in group meetings.
• Effective team player
• Coaches team on how to solve problems, plan, and meet organizational goals and objectives.

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

Comments:

Performance

• Listens and responds to issues and problems
• Works effectively in the department.
• Able to organize work.
• Effective in performing his/her job.
• Has great overall performance

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

Comments:

Results Oriented

• Helps others when free-time is available.
• Inspires and motivates co-workers to be productive and energetic at work
• Works toward achievement of goals even when confronted with obstacles.
• Encourages a high-energy, fun work environment and coaches others on how to do the same
• 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

• Ensures that all supervisors are aware of regulatory and compliance measures.
• Identifies and addresses safety needs.
• Participates in safety training when available.
• Mitigates hazards and safety issues that arise.
• Participates in safety training as applicable.

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

Comments:

Entrepreneurship

• Encourages dynamic growth opportunities.
• Devotes a certain amount of time and effort to developing new business opportunities.
• Balances risks and rewards when making decisions.
• Finds unique ways to go around barriers to success.
• Can work effectively in an environment of uncertainty.

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.