Feedback - 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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Feedback

• Embraces feedback to help to build self-awareness.
• Provides frequent and effective feedback to subordinates.
• Uses feedback as a catalyst for development, aligning suggestions with role expectations and organizational goals.
• Welcomes feedback as a catalyst for self-reflection and development.
• Welcomes feedback from others about strengths and areas for improvement.

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

Comments:

Passion To Learn

• Takes advantage of training opportunities when they arise.
• Embraces new technology and procedures.
• Is open to feedback from others.
• Recognizes own areas for development and consciously seeks assignments that will provide practice in areas of developmental need.
• Inspires others to learn new things.

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

Comments:

Adaptability

• Able to meet the needs of various stakeholders.
• Adapts policies to better meet the needs of employees.
• Integrates new core values of the company.
• Is open to changes in policies and procedures.
• Is aware of changes to team personnel.

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

Comments:

Change Management

• Implements planned structural and organizational changes to maintain a positive direction for the company/department.
• Facilitates the implementation of production line changes.
• Introduces structural changes to the team/department.
• Facilitates change with minimal resistance.
• Helps teams and department overcome hurdles to achieving necessary changes.

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

Comments:

Innovation

• Empowers employees to create innovative solutions to problems.
• Improves and makes systems more efficient.
• Looks beyond company for new ideas and innovative approaches.
• Encourages managers to "think outside the box".
• Champion disruptive innovations to open new market opportunities and redefine industry standards.

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.