Initiative - 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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Initiative

• Maintains momentum on long-term initiatives despite shifting priorities or limited support.
• Analyzes the needs of the situation and acts before being told to do so.
• Takes action to establish clear and concise deadlines for tasks to be completed.
• Introduces changes that reduce operational costs or increase revenue.
• Escalates strategically when necessary to unblock stalled efforts, while maintaining professionalism.

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

Comments:

Integrity

• Inspires others to perform at their best by fostering a culture of integrity and achievement within the organization.
• Works towards developing an environment built upon trust
• Can be trusted by others all the time and in every circumstance.
• Treats everyone with fairness and respect, regardless of their position or status within the organization.
• Freely offers sound information and advice.

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

Comments:

Professional Development

• Keep themselves up-to-date of technical/professional issues
• Contributing fully to the extent of their skills
• Demonstrate enthusiasm and a willingness to learn new skills and knowledge
• Quickly acquire and apply new knowledge and skills when needed
• Seeks opportunities for professional development.

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

Comments:

Cultural Awareness

• Seeks clarification to avoid misunderstandings.
• Seeks to reduce obstacles in communication that might arise from cultural differences.
• Creates safe spaces for employees to share cultural perspectives and experiences.
• Upholds inclusive policies that protect cultural expression and identity in the workplace.
• Interacts effectively with people from different cultural backgrounds.

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

Comments:

Planning

• Effectively uses logistics planning to reduce supply delays.
• Able to stay organized and focused using excellent planning skills.
• Able to identify the needs of the department before a major change.
• Creates to-do lists to make sure nothing is missed.
• Develops good plans used for logistics.

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.