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
Builds and maintains the trust of others.
Consistently keeps commitments.
Works in a way that makes others want to work with her/him.
Takes care to maintain confidential information.
Is trustworthy; is someone I can trust.
Adaptability	Agree	Unsure	Disagree	N/A
Adjusts plans to meet the needs of new constraints.
Performs a wide range of tasks, responds to changes in direction and priorities and accepts new challenges, responsibilities, and assignments.
Is open to change and adjusts plans when needed.
Able to adjust to changes as needed.
Adjusts plans to meet new situations.
Integrity	Agree	Unsure	Disagree	N/A
Protects the integrity and confidentiality of information
Fosters an environment built upon trust.
Does what was promised.
Fosters a high standard of ethics and integrity.
Accepts responsibility for mistakes.
Management	Agree	Unsure	Disagree	N/A
Is ready to offer help
Takes responsibility for things that go wrong
Sets an example for others to follow
Delegate tasks effectively
Makes you feel enthusiastic about your work
Initiative	Agree	Unsure	Disagree	N/A
Looks to start work on new projects without waiting for direction from the manager.
Encourages others on the team to suggest process improvements.
Guides strategic initiatives to advance the department/organization.
Initiates the development of new products.
Acts with urgency when time is of the essence.
Technical	Agree	Unsure	Disagree	N/A
Demonstrates mastery of the technical competencies required in his/her work.
Is knowledgeable of procedures or systems necessary for the job.
Willingly shares information and expertise; sought out as resource by others
Willingly shares his/her technical expertise; sought out as resource by others
Seeks information from others as needed.
Interpersonal Skills	Agree	Unsure	Disagree	N/A
Honesty and integrity are core tenets of interpersonal relationships.
Expresses appreciation of other's work.
Gives good advice and suggestions to coworkers.
Offers praise to colleagues who have successfully completed major projects.
Demonstrates a high degree of ethics and integrity in the workplace.
Responsible	Agree	Unsure	Disagree	N/A
Sets a good example.
Sets high personal standards of performance.
Behavior is ethical and honest.
Holds herself / himself accountable to goals / objectives
Sets a good example
Coaching	Agree	Unsure	Disagree	N/A
Helps employees to understand responsibilities, authority, and expectations.
Helps employees to maintain high personal standards.
Develops the skills and capabilities of others.
Conducts regular performance appraisals and feedback.
Meets regularly with employees to coach them on areas that will enhance their performance
Others	Agree	Unsure	Disagree	N/A
Supports the efforts of other employees in implementing solutions to problems.
Treats others with respect and dignity.
Works across boundaries within the organization.
Forms working relationships with employees from other departments.
Helpful

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.