Action - 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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Action

• Takes responsibility for actions.
• Leverages skills and resources to exceed expectations on projects.
• Takes proactive steps to address potential issues before they became a problem.
• Works quickly to get the job done.
• Approves purchase requests in a timely manner.

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

Comments:

Professional Development

• Quickly acquire and apply new knowledge and skills when needed
• Seeks opportunities for continuous learning.
• Allows employees to fully participate in employee training and professional development.
• Encourages employees to take courses relevant to their job.
• Keep themselves up-to-date of technical/professional issues

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

Comments:

Decision Making

• Does not lose sight of the big picture when making decisions
• Willing to change their strategy if new information arises.
• Filters choices through company values, legal requirements, and long-term goals.
• Connects unrelated concepts or data points to form innovative solutions that others may overlook.
• Applies creative reasoning in making decisions.

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

Comments:

Interpersonal Skills

• Follows up on inquiries in a timely manner.
• Embraces the differences in individuals that comprise the team.
• Addresses critical customer issues in a timely manner.
• Easily approachable.
• Gives good advice and suggestions to coworkers.

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

Comments:

Others

• Constructively receives criticism and suggestions from others.
• Is able to see issues from others' perspectives.
• Forms working relationships with employees from other departments.
• Works across boundaries within the organization.
• Includes others in the decision making processes.

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.