Trustworthy - 360 Degree Feedback Survey Sample #10

360 Feedback Survey

Instructions

Thank you for providing feedback for the recipient above. As you respond, please draw on your first-hand experience with this individual in the past 12 months. Rate each item using the scale shown. If you don't feel you have enough first-hand information to rate a certain item, please choose the Not Applicable option. Comments can be very helpful; at a minimum where you give a particularly high or low rating, please share your reasons in the comment section for that competency. Your responses will be compiled with feedback from others and presented to the recipient to help guide their ongoing development.

Partially completed forms can be saved by using the Save/Still Working button at the bottom of the page. You may return at a later time to complete/edit the form. Your saved responses will be shown each time you re-visit the feedback form. When you are certain that you have completed your responses and will be not making any changes, click the Complete button.

Trustworthy

• Is a person you can trust.
• Delivers on promises made.
• Communicates an understanding of the other person's interests, needs and concerns.
• Demonstrates congruence between statements and actions.
• Consistently keeps commitments.

If [Participant Name] were to make improvements in Trustworthy, what are your suggestions for how he/she can improve this?

Responsible

• Responsible for setting the vision of the department.
• Is a person you can trust.
• Behavior is ethical and honest.
• Works in a way that makes others want to work with her/him.
• ...takes personal responsibility for results.

If [Participant Name] were to make improvements in Responsible, what are your suggestions for how he/she can improve this?

Initiative

• Coach others to foster an environment which can adapt quickly and willingly to rapid change.
• Takes the initiative to change the direction or course of events.
• Seeks and utilizes opportunities for continuous learning and self-development.
• Takes action without being asked.
• Prepares for unexpected contingencies.

If [Participant Name] were to make improvements in Initiative, what are your suggestions for how he/she can improve this?

Excellence

• Is planful and organized.
• Can be counted on to add value wherever they are involved.
• Demonstrates the analytical skills to do their job.
• Keeps themselves and others focused on constant improvement.
• Produces high quality work.

If [Participant Name] were to make improvements in Excellence, what are your suggestions for how he/she can improve this?

Negotiation

• Stays calm and focuses on the core issues to be discussed.
• Changes communication styles to meet the listener's needs.
• Maintains communication channels between parties in the negotiation.
• Able to adapt to changing situations.
• Is able to decline bad ideas to avoid making poor decisions.

If [Participant Name] were to make improvements in Negotiation, what are your suggestions for how he/she can improve this?

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

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

Strengths


Areas for Development


Please give any final comments or suggestions for [Participant Name Here]'s assessment.