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360 Degree Survey

In an ongoing effort to reinforce performance coaching fundamentals, you are asked to respond to the statements that follow. Please read each statement carefully, refer to the rating scale provided, and decide to what extent ________ engages in the behavior described.

You will use a 7-point rating scale, from 'Needs Significant Improvement' to 'Role Model'.

In assessing each statement please ensure your selection accurately reflects your experience (i.e., do not respond on the basis of "what you would like to do" or, "what you think the right answer is.") Respond on the basis of your actual observations.

When you have completed the assessment click "Complete". Your assessment will be processed and combined with the results of the "other assessments" filled out by other, peers, direct reports and supervisors. _______ will receive summary feedback at the conclusion of this survey project.

The data you receive will be confidential (with the exception of supervisor's feedback). You will not be able to determine the origin of any individual assessment, and your feedback summary will not be forwarded to any direct reports. This Leadership Feedback exercise is intended for your ongoing growth and development.

To what extent does _______ typically engage in the following behaviors? Select the response option that best applies to each statement.

Describe the greatest strengths of this person with regard to his/her overall effectiveness in performing his/her current responsibilities.

Describe the most important things this person could improve upon in order to increase his/her overall effectiveness in performing his/her current responsibilities.

Overall, how would you rate performance and why?

-Excellent

-Good

-Average

-Poor

Other Comments:

Status of the Form

Upon clicking this button any responses will be saved. You can still return to the form to enter/review responses.

	Needs Significant Improvement	Needs Some Development	Capable and Effective	Role Model
Gives accurate and constructive feedback
Effective in building high functioning teams
Facilitates opportunities for employee development
Open to feedback from others
Is an effective team member
Identifies new opportunities for the department
Provides accurate information to others
Acts as a coach and mentor to subordinates
Completes a high amount of work

	Needs Significant Improvement	Needs Some Development	Capable and Effective	Role Model
Supports the company strategic goals
Understands the factors that impact the department
Open to the suggestions from others
Effective leader in stressful situations
Resolves employee conflicts for a win-win conclusion
Listens to employee ideas and proposals
Incorporates feedback from others
Plans and develops strategic objectives
Able to communicate the vision of the organization
Supports the professional development of others

	Needs Significant Improvement	Needs Some Development	Capable and Effective	Role Model
Looks for innovative ways to solve problems
Is a trustworthy person
Shares the values of the organization
Engages in professional development opportunities
Solves the root causes of problems
Shows employees how their job supports the department
Gains commitment by influence and persuasion
Communicates effectively in presentations
Understands how organizational changes affect employees
Ensures everyone understands the discussions

	Needs Significant Improvement	Needs Some Development	Capable and Effective	Role Model
Has a high quality of work
Checks details of work
Obtains "buy-in" from employees when making organizational changes
Effective in communicating ideas and concepts
Aligns the goals of the department with the organization
Respected by other team members
Effective in making decisions
Provides assistance and support to other team members when needed
Follows up on suggestions of co-workers

	Needs Significant Improvement	Needs Some Development	Capable and Effective	Role Model
Maintains the trust and confidence of others
Works diligently toward the completion of goals
Is open and approachable
Supports the use of technology and new software
Seeks collaboration and teamwork among departments and team members
Effective in analyzing data
Supports the professional development of others
Converts strategic plans into action and results
Encourages innovative thinking by others