Rater:
You are providing feedback to:




Instructions

You have been asked to evaluate as part of a 360-degree developmental evaluation process. Other employees will also provide with feedback. In this manner, they will be provided with a comprehensive, multi-perspective view of their performance. The end goal is to provide them with feedback so as to allow them to improve their performance, resulting in improved team performance, and organizational effectiveness.

Please provide feedback using the form below. If you are not able to respond to an item, select "Not Applicable" or leave it blank and go on to the next item. When you have finished, press the SAVE or COMPLETED button at the bottom of the form.

Note: When you enter text comments into the boxes below, please focus your comments on work behaviors and styles. The comments that you type will be viewed by the individual receiving the feedback. Do not enter personal information about yourself unless you want this individual to know you are the author of these comments.

To what extent does exhibit the following ...

While these items may be grouped by competency in the results, they do not have to be grouped by competency when shown to the participant. In this example, the order of items was randomly determined.
Never or
to a very
small extent		 Sometimes
or to a
less than
average extent		    Average    Almost always
or to a
large extent		 Always or to
a very
great extent
  1. Respects others and supports their professional development
  1. Works effectively as a team member
  1. Supports the professional development of others
  1. Listens to employees
  1. Effective in gaining commitment by persuasion
  1. Able to communicate the vision of the organization
  1. Shows employees how their job supports the organizational
  1. Understands the market factors that impact the organization
  1. Seeks professional development opportunities

Never or
to a very
small extent		 Sometimes
or to a
less than
average extent		    Average    Almost always
or to a
large extent		 Always or to
a very
great extent
  1. Is strict about checking details
  1. Follows up on suggestions of co-workers
  1. Is open to constructive feedback
  1. Effective in making decisions
  1. Effective in communicating ideas and concepts
  1. Gives other honest feedback
  1. Incorporates feedback from others
  1. Has a high standard of work
  1. Works dilligently toward the completion of goals

Never or
to a very
small extent		 Sometimes
or to a
less than
average extent		    Average    Almost always
or to a
large extent		 Always or to
a very
great extent
  1. Is open and approachable
  1. Effective in analyzing data
  1. Solves problems at the root cause
  1. Identifies opportunities to achieve goals
  1. Converts strategic plans into action
  1. Aligns the goals of the department with the organization
  1. Obtains "buy-in" from employees when making organizational changes
  1. Is trustworkthy
  1. Respected by other team members

Never or
to a very
small extent		 Sometimes
or to a
less than
average extent		    Average    Almost always
or to a
large extent		 Always or to
a very
great extent
  1. Open to the suggestions from others
  1. Effective in building high performance teams
  1. Communicates effectively in presentations
  1. Has a high work ethic
  1. Supports the use of advanced technology
  1. Understands how organizational changes affect employees
  1. Seeks collaboration and teamwork among departments and team members
  1. Supports strategic goals
  1. Acts as a coach and mentor

Never or
to a very
small extent		 Sometimes
or to a
less than
average extent		    Average    Almost always
or to a
large extent		 Always or to
a very
great extent
  1. Effective leader in stressful situations
  1. Able to resolve employee conflicts
  1. Looks for innovative ways to solve problems
  1. Effective in planning and developing strategic objectives
  1. Supports professional development of subordinates
  1. Communicates effectively with individuals outside the department
  1. Facilitate learning opportunities for others
  1. Is trustworthy and respected by others
  1. Shares the values of the organization
  1. Encourages innovative thinking by others
  1. Brings clarity to discussions

Use caution when entering written comments to make sure that the comments provide
constructive feedback. The comments you enter will be shown to the individual receiving
the feedback. Your confidentiality will be maintained in that the person receiving feedback
will not see the name of the participants who entered the comments or ratings.

  1. Please describe this person's strengths:


  1. Please describe areas of development for this individual:


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