360 Feedback Assessment

Completed by peers, direct reports, internal stakeholders, and by the participant as a self-rating. The same thirty-five statements as the Talent Assessment Form, rated for how often you have seen each one. Every statement needs an answer before the form can be submitted.

Section 1Who you are rating, and who you are

Your individual answers are never shown to the person being rated. Responses are combined across everyone in your rater group before anything is reported, and no group is reported unless it has at least four respondents. Please answer from what you have actually seen rather than from reputation.

Section 2Behavioural statements

Rate how often you have seen this person do each thing. If you have had no chance to observe it, choose No basis — that answer is set aside rather than counted against them. Every statement needs an answer.

Leadership Potential Indicator	No.	LPI Sub-Element	Behavioural statement	How often have you seen this?

Section 3In your own words

Writing useful feedback: the SBI model

Situation: When and where it happened.
Behaviour: What the person actually did or said — observable actions, not traits.
Impact: What resulted, for the work, the team or the customer.

Example — “In the June vendor review (situation), he restated Procurement's objection in their own terms before answering it, and offered a phased option neither side had raised (behaviour). The meeting closed with an agreement that had been stuck for six weeks (impact).”

Not useful — “Great communicator.” “Needs to be more strategic.” These give the person nothing to act on.

What does this person do well? Give one specific occasion. *

What would hold them back in a bigger role? Give one specific occasion. *

If they changed one thing, what should it be? *

Your ratings summaryAvailable once every statement is answered

Thank you. Here is a summary of what you have submitted. This is your view alone — it will be combined with other raters before anyone sees it.

—of the statements you could rate were answered Often or Consistently

Leadership Potential Indicator	Often or better	Rated	No basis	Score

The submit button unlocks when every statement is answered.

Writing useful feedback: the SBI model