Technical Skills - 360 Degree Feedback Survey Sample #7

360 Feedback Survey

Self-Assessment Form Instructions

is administering a new web-based survey tool which is designed to gather broad feedback as it relates to core competencies and role responsibilities that are important for the on-going success of our organization. All Leadership Team Members will be participating at this time.

In this regard, you need to complete a self-assessment questionnaire form (below).
Your responses will be combined with the responses from your peers and direct reports. This tool is intended to gather broad feedback in the core competencies and role responsibilities that are important for the on-going success of our organization.

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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Technical	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
You seek information from others as needed.
You are knowledgeable of procedures or systems necessary for the job.
You willingly share information and expertise; sought out as resource by others
You willingly share your technical expertise; sought out as resource by others
You are naturally sought out by people outside your particular area for advice and opinion on a broad range of matters - not necessarily solely legal advice.
If you were to make improvements in Technical, what are your suggestions for how you can improve this?
Self Management	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
You are aware of personal impact on others and adjusts behavior to create a positive leadership presence.
You set an example for associates during stressful periods by maintaining a positive, can-do attitude.
You step away from a situation to process appropriate response.
You use patience and self-control in working with customers and associates.
You consciously control own negative emotions in order to keep team morale up.
If you were to make improvements in Self Management, what are your suggestions for how you can improve this?
Managing Risk	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
You create informative guides regarding potential risks and risky behaviors.
I determine if the level of risk is tolerable.
I add value to the organization through acceptance of certain risk.
I identify the controls needed.
I foster an awareness and a shared responsibility for managing risk at all levels of the Company.
If you were to make improvements in Managing Risk, what are your suggestions for how you can improve this?
Client Focus	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
You deliver high quality products to the client.
You provide a high level of service to clients.
I build long term relationships with clients.
You get feedback from the client on a weekly basis.
You address client complaints immediately.
If you were to make improvements in Client Focus, what are your suggestions for how you can improve this?
Recognition	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
You say "thank you" to show appreciation for work of others.
You reinforce and reward employees for accomplishing necessary goals.
You make people around them feel appreciated and valued.
You readily share credit and gives others opportunity for visibility.
You recognize individuals for a specific outstanding achievement.
If you were to make improvements in Recognition, what are your suggestions for how you can improve this?
Company	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
You understand how decisions impact other business units beyond your immediate department of work group.
You express loyalty and dedication to [Company] in interactions with others.
You understand the use of [Company] products and services.
You follow existing procedures and processes.
You understand the "basics" as to how [Company] functions/operates.
If you were to make improvements in Company, what are your suggestions for how you can improve this?
Planning	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
I determine the steps required for completion of a task.
You purchase equipment and software that will be needed in the future.
You anticipate obstacles and ways to overcome them.
I identify resource requirements that may impact the development of the 5-year plan.
You set the appropriate sequence of tasks to efficiently achieve the goal.
If you were to make improvements in Planning, what are your suggestions for how you can improve this?

36. Strengths
    
    
    
37. Areas for Development
    
    
    
38. Please give any final comments or suggestions for [Participant Name Here]'s assessment.