Trustworthy - 360 Degree Feedback Survey Sample #12

360 Feedback Survey

Instructions

We appreciate you taking the time to provide valuable feedback for the individual mentioned above. As you respond, please draw on your first-hand experience with this individual in the past 12 months. Your insights are crucial in offering a comprehensive evaluation. Please rate each item using the scale provided. If you find that you do not have sufficient first-hand knowledge to rate a particular item, select the Not Applicable option.

In addition to the ratings, we encourage you to include comments where possible. These comments are particularly useful when you give a very high or very low rating, as they provide context and clarity regarding your assessment. Explaining your reasons in the comment section helps ensure that your feedback is constructive and actionable.

Your responses, combined with feedback from other contributors, will be compiled and presented to the individual. This collective feedback aims to support their continuous growth and development by highlighting strengths and identifying areas for improvement. Your thoughtful participation is essential in helping them achieve their full potential.

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.

To what extent does [Participant Name] exhibit the following ...

SELECT the rating that best reflects the employee's performance in the areas listed.

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Trustworthy

• Is trustworthy; is someone I can trust.
• Takes care to maintain confidential information.
• Takes ownership, delivers on commitments
• Demonstrates congruence between statements and actions.
• Is a person you can trust.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Leadership

• Implements decision and evaluates results.
• Holds team members accountable to commitments made
• Holds team members accountable for delivering results on time and at a high standard.
• Coaches employees about the significance of the Company within our industry.
• Uses situational leadership employing the appropriate leadership style to maximize performance given the situation.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Problem Solving

• Uses data analytics to identify patterns and trends that may indicate emerging issues.
• Is a good problem solver and decision maker.
• Implements solutions to solve the problem.
• Effective in developing innovative products and services.
• Able to respond swiftly to keep the problem-solving process moving forward without unnecessary delays.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Results Oriented

• Is considered a high achiever.
• Directs team in prioritizing daily work activities
• Produces a high volume of work.
• Uses dashboards or visual tools to communicate progress transparently.
• Anticipates customer needs and adjusts workflows to ensure satisfaction.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Empowering Others

• Views others in the department as valued assets to be trained and employed.
• Willing to share in the decision making process.
• Gives employees the opportunity to make their own decisions at work.
• Allows employees to take ownership of their work.
• Delegates authority to employees and allows them to make their own decisions.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Strengths


Areas for Development


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