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 .

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Teamwork	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Effective team player
Encourages other team members to adopt new procedures.
Able to work closely other team members who are considered to be difficult to work with.
Creates opportunities to learn with other team members
Works with other team members to achieve objectives.
Willing to listen to the ideas of other team members.
Focuses on understanding the other team member's message.
Treats other team members with respect.
Is able to accurately paraphrase and summarize what other team members have said.
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
Respectful of others in group discussions.
Listens to the ideas and suggestions from others.
Actively seeks opportunities to work with colleagues to address and resolve challenges.
Addresses interpersonal issues with a collaborative mindset.
Works to create innovative ideas from the collaboration with others.
Fosters a collaborative work environment where everyone feels committed to achieve common goals.
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
Able to settle disputes equitably.
Breaks down conflict into component parts (e.g., interests, emotions, miscommunications) to isolate key drivers.
Identifies and takes steps to prevent potential confrontations.
Creates an environment where concerns can be voiced early, making it easier to address issues before they escalate.
Achieves mutually acceptable solutions through collaborative efforts by both parties.
Identifies patterns in recurring conflicts, using historical data or behavioral trends to inform resolution strategies.
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
Has a strategic awareness on how to promote the organization.
Able to adapt the department to changing business demands and climate.
Devotes a certain amount of time and effort to developing new business opportunities.
Encourages risk taking for developing potential business opportunities.
Exhibits determination and passion in completion of goals.
Is comfortable operating in an environment of uncertainty.
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
Keeps the supervisor informed about achievements and milestones.
Takes on challenging questions and provides instant answers.
Marks their status as "available" to signal they are open for communication.
Receives and answers questions - on the spot. S/he has a willingness to address the tough questions.
Faces the person when speaking or listening to engage in direct communication.
Responds to questions with accurate and complete answers
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
Effectively organizes resources and plans
Works effectively in the department.
Shown significant improvement in job performance.
Works well in this position.
Has great overall performance
Listens and responds to issues and problems
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
Is considered a high achiever.
Demonstrates persistence and focus even when facing repeated setbacks.
Quickly analyzes the situation to determine the most pressing needs.
Establishes benchmarks to be met when working on projects.
Produces a high volume of work.
Adjusts timelines and deliverables in response to evolving stakeholder needs.
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
Develops a strong safety culture.
Participates in safety training as applicable.
Works to implement corrective safety measures.
Develops a culture of safety.
Is not afraid to question a potential safety issue observed in the workplace.
Keeps accurate safety records.
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.