Trustworthy

360 Feedback Survey

Questionnaires Measuring Trustworthiness:
Survey 1 (4-point scale; Competency Comments)
Survey 2 (4-point scale; Competency Comments)
Survey 3 (5-point scale; Competency Comments)
Survey 4 (5-point scale; radio buttons)
Survey 5 (4-point scale; words)
Survey 6 (4-point scale; words)
Survey 7 (5-point scale; competency comments; N/A)
Survey 8 (3-point scale; Agree/Disagree words; N/A)
Survey 9 (3-point scale; Strength/Development; N/A)
Survey 10 (Comment boxes only)
Survey 11 (Single rating per competency)
Survey 12 (Slide-bar scale)

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.

Competencies Included:
Trustworthy, Leadership, Problem Solving, Results Oriented, Empowering Others

Sample Result Document:
Sample Results

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.

Takes ownership, delivers on commitments
Builds and maintains the trust of others.
Communicates an understanding of the other person's interests, needs and concerns.
Takes care to maintain confidential information.
Works in a way that makes others want to work with her/him.

Needs Improvement	Fully Proficient	Excels/ Role Model

Click this box to make your rating

Comments:

Leadership

Holds others accountable for their actions.
Able to influence others.
Gives inspiring presentations or discussions.
Sets a high level of performance expectations and challenges others to do the same.
Motivates and challenges employees to attain a shared vision.

Needs Improvement	Fully Proficient	Excels/ Role Model

Click this box to make your rating

Comments:

Problem Solving

Finds creative ways to get things done with limited resources.
Effective in solving problems.
Ability to develop innovative solutions to problems.
Identifies and assesses all potential responses to a problem.
Understands the root causes of problems.

Needs Improvement	Fully Proficient	Excels/ Role Model

Click this box to make your rating

Comments:

Results Oriented

Sets a common goals for the team.
Is a high achiever.
Ensures the team understands the objective that needs to be completed.
Quickly analyzes the situation to determine the most pressing needs.
Produces a high volume of work.

Needs Improvement	Fully Proficient	Excels/ Role Model

Click this box to make your rating

Comments:

Empowering Others

Creates opportunities for employees to exercise their independence.
Recognizes the importance of a healthy work/life balance.
Assigns tasks that allow employees to use their critical thinking skills.
Supports the decisions of others.
Expresses confidence in the abilities of others.

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.