Trustworthy - 360 Degree Feedback Survey Sample #12

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.

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

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

Trustworthy

• Takes care to maintain confidential information.
• Consistently keeps commitments.
• Communicates an understanding of the other person's interests, needs and concerns.
• Takes ownership, delivers on commitments
• Is a person you can trust.

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

Comments:

Leadership

• Gives direct, constructive, and actionable feedback.
• Gives inspiring presentations or discussions.
• Highly effective supervisor.
• Demonstrates leadership and courage in critical situations.
• Motivates others to reach and exceed organizational goals and objectives.

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

Comments:

Problem Solving

• Is a good problem solver and decision maker
• Makes judgments based upon relevant information.
• Effective in solving problems.
• Understands the root causes of problems.
• Actively seeks the root cause of a problem.

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

Comments:

Results Oriented

• Encourages a high-energy, fun work environment and coaches others on how to do the same
• Stays focused on meeting the needs of customers.
• Works toward achievement of goals even when confronted with obstacles.
• Does not become distracted by non-issues or interruptions.
• Explains the "whys" behind organizational objectives

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

Comments:

Empowering Others

• Avoids micromanaging their employees.
• Is confident in the abilities of employees assigned important tasks.
• Gives employees the opportunity to make their own decisions at work.
• Trusts employees to complete tasks assigned.
• Recognizes the accomplishments of employees when they complete important assignments.

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.