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  2. 2012
  3. September
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Hi,

You have been selected to offer feedback on [ENTER NAME HERE] by completing the following 360 Degree Feedback survey.

Your feedback is an important part of a 1:1 coaching process and should reflect your own observations.

Your feedback will be kept anonymous, unless you tell us you are this person's manager. Direct manager feedback will be shared. Your feedback is an important part of helping raise self-awareness and accelerate development of behaviors to continue and change.

Please respond by <>.

Thank you for participating.
 
 
Personal Contribution
Don’t Know or Haven’t Observed (0) Ineffective (1) Somewhat Ineffective (2) Effective (3) Very Effective (4) Highly Effective (5)
Understands role and responsibilities
Has the right level of knowledge & skill to deliver on responsibilities
Proactive; takes initiative
Focuses on results
Accountable; hits goals and milestones
Creative, generates ideas
Prioritizes own work appropriately
 
 
Collaboration/Teamwork
Don’t Know or Haven’t Observed (0) Ineffective (1) Somewhat Ineffective (2) Effective (3) Very Effective (4) Highly Effective (5)
Actively shares thoughts, opinions & ideas
Solicits and values input
Is open to others disagreeing with him/her; doesn't avoid necessary conflict
Modifies plans to include others’ ideas
Contributes to positive work environment
Team player
Actively participates in meetings
Respects others
 
 
Decision Making
Don’t Know or Haven’t Observed (0) Ineffective (1) Somewhat Ineffective (2) Effective (3) Very Effective (4) Highly Effective (5)
Knows when to escalate issues
Takes personal responsibility for decisions made
Learns from mistakes
 
 
Communication
Don’t Know or Haven’t Observed (0) Ineffective (1) Somewhat Ineffective (2) Effective (3) Very Effective (4) Highly Effective (5)
Makes sure appropriate people have the right information
Responds to others’ questions in a timely fashion
Works to keep lines of communication open with stakeholders, management and team members
Is engaging and adapts message/content to fit the audience's needs
Communicates clearly, concisely and consistently
Shows confidence and executive presence, speaks with conviction
 
 
Personal Attributes
Don’t Know or Haven’t Observed (0) Ineffective (1) Somewhat Ineffective (2) Effective (3) Very Effective (4) Highly Effective (5)
Demonstrates emotional intelligence
Interacts well with others
Is honest, trustworthy
Is respected by others
Self-aware
Shows support and appreciation to others
Develops networks and relationships
 
 
 
What behaviors do you admire most in this person?
   
 
 
 
What is one suggestion you have to make this person more effective right now?
   
 
 
 
Are there any additional comments you'd like to make?
   
 
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