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
Takes care to maintain confidential information.
Demonstrates congruence between statements and actions.
Delivers on promises made.
Takes ownership, delivers on commitments
Seeks to mitigate grievances by clarifying intentions and finding suitable remedies.
Adaptability	Agree	Unsure	Disagree	N/A
Adjusts tactics and strategies.
Is open to change and adjusts plans when needed.
Continually trying to improve skills to remain current.
Adjusts to the new vision and mission of the company.
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.
Demonstrates sincerity in actions with others.
Fosters a high standard of ethics and integrity.
Does what was promised.
Accepts responsibility for mistakes.
Management	Agree	Unsure	Disagree	N/A
Delegate tasks effectively
Makes you feel enthusiastic about your work
Sets an example for others to follow
Keep staff informed about what is happening in the company
Is ready to offer help
Initiative	Agree	Unsure	Disagree	N/A
When working on a problem in a team, they are often the first to suggest possible solutions.
Gladly seeks additional responsibilities.
Analyzes the needs of the situation and acts before being told to do so.
Takes on additional tasks without being asked or told to do so.
Updates the documentation as soon as the situation changes.
Technical	Agree	Unsure	Disagree	N/A
Willingly shares his/her technical expertise; sought out as resource by others
Demonstrates mastery of the technical competencies required in his/her work.
Is knowledgeable of procedures or systems necessary for the job.
Keeps current with technical advances within his/her professional discipline; embraces and applies new techniques and practices
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.
Interpersonal Skills	Agree	Unsure	Disagree	N/A
Uses tact, compassion, and sensitivity in interactions with others.
Is trusted by peers and co-workers; others are willing to confide in him/her
Effectively manages conflicts by dealing with them directly and immediately
Strives for win/win solutions
Able to work with individuals at all levels of the Company.
Responsible	Agree	Unsure	Disagree	N/A
Works in a way that makes others want to work with her/him.
...takes personal responsibility for results.
Responsible for setting the vision of the department.
Holds herself / himself accountable to goals / objectives
Behavior is ethical and honest.
Coaching	Agree	Unsure	Disagree	N/A
Helps employees to understand responsibilities, authority, and expectations.
Provides clear, motivating, and constructive feedback.
Helps employees to maintain high personal standards.
Conducts regular performance appraisals and feedback.
Coaches employees in how to strengthen knowledge and skills to improve work performance.
Others	Agree	Unsure	Disagree	N/A
Consistently demonstrates ability and willingness to trust others.
Treats others with respect and dignity.
Includes others in the decision making processes.
Is able to see issues from others' perspectives.
Works effectively with people 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.