Trustworthy - 360 Degree Feedback Survey Sample #8

Instructions

You have been selected to provide feedback for the manager listed above. Your feedback is an important part of 's leadership development process. 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 six to twelve months. Your responses will be merged with other people's feedback and presented to to guide them in their on-going development. Comments will be shared anonymously, as written, with the manager.

Method of use: As part of the review process, managers will receive feedback from peers and staff. It is recognized that not all participants will be able to assess an individual's performance in all areas. The feedback received will be utilized as input to the manager's performance and on-going development plan.

You may sign out at any time by pressing the Save button at the end of the form and then closing your browser. You may return later to pick up where you left off. When you are done, press the Complete button.



Please complete your response by .

Trustworthy	Agree	Unsure	Disagree	N/A
Is trustworthy; is someone I can trust.
Consistently keeps commitments.
Seeks to mitigate grievances by clarifying intentions and finding suitable remedies.
Delivers on promises made.
Is a person you can trust.
Adaptability	Agree	Unsure	Disagree	N/A
Is proactive and takes steps to prepare for changes in the workplace.
Adjusts priorities to changing business goals.
Performs a wide range of tasks, responds to changes in direction and priorities and accepts new challenges, responsibilities, and assignments.
Flexible and open to new ideas and encourages others to value change.
Ability to recognize the potential benefits of change, and create an infrastructure which supports change.
Integrity	Agree	Unsure	Disagree	N/A
Demonstrates honesty and truthfulness at all times.
Follows tasks to completion.
Demonstrates sincerity in actions with others.
Maintains strong relationships with others.
Fosters an environment built upon trust.
Management	Agree	Unsure	Disagree	N/A
Keep staff informed about what is happening in the company
Takes responsibility for things that go wrong
Delegate tasks effectively
Sets an example for others to follow
Is ready to offer help
Initiative	Agree	Unsure	Disagree	N/A
Seeks and utilizes opportunities for continuous learning and self-development.
Coach others to foster an environment which can adapt quickly and willingly to rapid change.
Immediately works to complete goals well before their deadline.
Takes action without being asked.
Takes decisive action to address problems, following up with relevant team members and coaching them on how to improve.
Technical	Agree	Unsure	Disagree	N/A
Seeks information from others as needed.
Demonstrates mastery of the technical competencies required in his/her work.
Knows how to produce high quality products/work.
Is naturally sought out by people outside his/her particular area for advice and opinion on a broad range of matters - not necessarily solely legal advice.
Willingly shares information and expertise; sought out as resource by others
Interpersonal Skills	Agree	Unsure	Disagree	N/A
Able to work with individuals at all levels of the Company.
Successfully resolves conflicts and grievances to a win-win solution.
Strives for win/win solutions
Uses tact, compassion, and sensitivity in interactions with others.
Is open and approachable
Responsible	Agree	Unsure	Disagree	N/A
Sets a good example
Sets a good example.
Sets high personal standards of performance.
Responsible for setting the vision of the department.
Acts as a resource without removing individual responsibility.
Coaching	Agree	Unsure	Disagree	N/A
Conducts regular performance appraisals and feedback.
Addresses employee behavior problems effectively.
Meets regularly with employees to coach them on areas that will enhance their performance
Helps employees to understand responsibilities, authority, and expectations.
Coaches employees in how to strengthen knowledge and skills to improve work performance.
Others	Agree	Unsure	Disagree	N/A
Treats others with respect and dignity.
...treats others with respect and dignity.
Consistently demonstrates ability and willingness to trust others.
Helpful
Forms working relationships with employees from other departments.

51. Overall, please rate the effectiveness of [Participant Name Here].
    

    5- Very Effective 4- Effective 3- Neither 2- Ineffective 1- Very Ineffective

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