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

• Demonstrates congruence between statements and actions.
• Takes care to maintain confidential information.
• Communicates an understanding of the other person's interests, needs and concerns.
• Demonstrates a sense of responsibility and commitment to public trust.
• Is a person you can trust.

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

Responsible

• Behavior is ethical and honest.
• Responsible for setting the vision of the department.
• Completes assigned work tasks.
• Acts as a resource without removing individual responsibility.
• Sets high personal standards of performance.

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

Initiative

• Cleans the workspace without being told.
• Builds strong interpersonal relationships upon first meeting.
• Seeks and utilizes opportunities for continuous learning and self-development.
• Volunteers time and effort toward the completion of important goals.
• Quickly comes to the aid of those who may need help.

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

Excellence

• Demonstrates the analytical skills to do their job.
• Keeps themselves and others focused on constant improvement.
• Takes a lot of pride in their work.
• Is planful and organized.
• Demonstrates the functional or technical skills necessary to do their job.

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

Negotiation

• Changes communication styles to meet the listener's needs.
• Maintains good interpersonal relationships with representatives from the other party.
• Maintains communication channels between parties in the negotiation.
• Leverages relationships with others to achieve goals.
• Able to say "no" when it is essential to maintaining quality and high standards.

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.