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 .

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Trustworthy	Agree	Unsure	Disagree	N/A
Communicates an understanding of the other person's interests, needs and concerns.
Is trustworthy; is someone I can trust.
Seeks to mitigate grievances by clarifying intentions and finding suitable remedies.
Consistently keeps commitments.
Works in a way that makes others want to work with her/him.
Adaptability	Agree	Unsure	Disagree	N/A
Adjusts plans and procedures.
Adapts to new environments.
Able to step in and help co-workers when needed.
Adjusts plans to meet new situations.
Able to quickly learn new ways of performing their job.
Integrity	Agree	Unsure	Disagree	N/A
Protects the integrity and confidentiality of information
Demonstrates sincerity in actions with others.
Develops trust and confidence from others.
Does what was promised.
Establishes relationships of trust, honesty, fairness, and integrity.
Management	Agree	Unsure	Disagree	N/A
Sets an example for others to follow
Makes you feel enthusiastic about your work
Delegate tasks effectively
Takes responsibility for things that go wrong
Keep staff informed about what is happening in the company
Initiative	Agree	Unsure	Disagree	N/A
Is proactive and gets things done.
When working on a problem in a team, they are often the first to suggest possible solutions.
Acts with urgency when time is of the essence.
Is a self-starter. Does not wait to be told to do something.
Creates solutions to problems as soon as an incident occurs.
Technical	Agree	Unsure	Disagree	N/A
Knows how to produce high quality products/work.
Uses expertise to identify issues and think through creative solutions to get a problem solved or objective accomplished.
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
Interpersonal Skills	Agree	Unsure	Disagree	N/A
Strives for win/win solutions
Adapts management style to meet the needs of the individual or situation.
Anticipates the concerns of other employees.
Works diligently to assist customers in finding the right products.
Is transparent and honest in communications, intentions, and actions.
Responsible	Agree	Unsure	Disagree	N/A
Sets a good example
Works in a way that makes others want to work with her/him.
Sets high personal standards of performance.
Is a person you can trust.
Acts as a resource without removing individual responsibility.
Coaching	Agree	Unsure	Disagree	N/A
Addresses employee behavior problems effectively.
Develops the skills and capabilities of others.
Helps employees to maintain high personal standards.
Coaches employees in how to strengthen knowledge and skills to improve work performance.
Helps employees to understand responsibilities, authority, and expectations.
Others	Agree	Unsure	Disagree	N/A
Consistently demonstrates ability and willingness to trust others.
Treats others with respect and dignity.
Helpful
Respects the opinions of other employees.
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.