Teamwork - 360 Degree Feedback Survey Sample #14

360 Feedback Survey

Instructions

Our company is excited to introduce a new web-based survey tool designed to gather comprehensive feedback on core competencies and role responsibilities critical to the ongoing success of our organization. The Leadership Team Members have unanimously agreed to participate in this initiative and are actively seeking your valuable feedback.

In this context, you have been specifically selected to provide insights on the manager listed above. Your feedback is a crucial component of our company's leadership development process. This tool is intended to capture broad and detailed feedback on the essential competencies and responsibilities that underpin our organization's sustained success and growth.

Your thoughtful and candid responses will play a significant role in guiding the professional development of our leadership team. By reflecting on your experiences and interactions with the manager over the past six to twelve months, you will help us identify strengths, areas for improvement, and opportunities for growth. Your feedback will be combined with that of others and presented to the manager to support their ongoing development. Rest assured, your comments will be shared anonymously, ensuring your privacy while contributing to a culture of continuous improvement and excellence.

In responding to the assessment form, please think about your experiences working with this individual during the last twelve (12) months. Your responses will be merged with other people's feedback and presented to guide them in their on-going development. Comments will be shared anonymously, as written, with the manager, unless you indicate otherwise.

You are only being asked to rate 8 competencies. Each competency will have a variety of statements that are grouped by 4 Performance Levels. Click on the level that best describes this individual.

Please ensure that your submission is made between .

Teamwork	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Helps the team to bounce back from obstacles.
Takes the time to actively listen to other team member's perspectives.
Facilitates effective teamwork during periods of change.
Demonstrates a willingness to work with the team.
Fosters an environment that promotes active listening on the team.
Appreciates the input from other team members.
Encourages collaboration with other departments.
Encourages teamwork and collaboration.
Promotes a team spirit within and outside department; partners with other groups.
If [Participant Name] were to make improvements in Teamwork, what are your suggestions for how he/she can improve this?
Collaboration	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Encourages collaboration with other departments.
Listens and attends to the ideas from others.
Has the confidence and trust of other partners.
Works with others to achieve common objectives.
Encourages open communication to support a collaborative environment.
Respects other committee members.
If [Participant Name] were to make improvements in Collaboration, what are your suggestions for how he/she can improve this?
Conflict Management	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Is open and honest to avoid misunderstandings.
Determines who has the autonomy (authority) to make the decisions necessary to end the conflict.
Seeks to have both sides voluntarily work together to resolve their differences.
Discusses conflict situations with supervisor.
Identifies the root sources of conflict.
Guides others toward establishing strong relationships.
If [Participant Name] were to make improvements in Conflict Management, what are your suggestions for how he/she can improve this?
Entrepreneurship	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Encourages risk taking for developing potential business opportunities.
Encourages dynamic growth opportunities.
Excellent at managing relationships with stakeholders.
Is comfortable operating in an environment of uncertainty.
Finds unique ways to go around barriers to success.
Balances risks and rewards when making decisions.
If [Participant Name] were to make improvements in Entrepreneurship, what are your suggestions for how he/she can improve this?
Communication Skills	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Is willing to give feedback to others even if that feedback is critical of their approach.
Listens to others' points of view with an open mind
Articulates ideas clearly and assertively.
Open to receiving feedback from others.
Is professional at all times--never ridiculing, mocking or undermining peers or subordinates.
Recaps action steps from meetings to ensure clarity and execution.
If [Participant Name] were to make improvements in Communication Skills, what are your suggestions for how he/she can improve this?
Performance	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
...Produce Quality
Able to organize work.
Has great overall performance
Works well in this position.
Listens and responds to issues and problems
Effectively organizes resources and plans
If [Participant Name] were to make improvements in Performance, what are your suggestions for how he/she can improve this?
Results Oriented	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Persists in seeking objectives despite obstacles or setbacks.
Willing to take on new assignments to help increase production.
Achieves high levels of performance.
Gives extra effort to solve problems and get work done on time.
Completes all assigned tasks.
Completes all required coursework.
If [Participant Name] were to make improvements in Results Oriented, what are your suggestions for how he/she can improve this?
Safety	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Works to implement corrective safety measures.
Identifies and addresses safety needs.
Seeks to reduce the likelihood of accidents.
Participates in safety training when available.
Participates in safety training when offered.
Supports safety programs and procedures.
If [Participant Name] were to make improvements in Safety, what are your suggestions for how he/she can improve this?

52. Strengths
    
    
    
53. Areas for Development
    
    
    
54. Please give any final comments or suggestions for [Participant Name Here]'s assessment.