360 Peer Evaluation - Centric Dynamix Inc.

Please evaluate the program participant. It is crucial that you answer all questions honestly. Read each question/statement and respond using the scale below: Always Frequently Occasionally Seldom Rarely/Never Please do not put your name on the form as your evaluation is anonymous to the program participant.

* Name of person you are evaluating.

Evaluate how often the participant uses words similar to those listed below when communicating with people. It is important to look at the meaning of each instead of the exact words used.

* Let me give you a hand with that.

* I understand your point of view.

* What were you thinking?

* What else was I supposed to do?

* Who the hell do you think you are?

* Great job! Fantastic!

* What did I tell you?

* F&#$ you!

* How do you feel about this situation?

* Don’t worry, it will be all right.

* I don’t want to talk about it!

* We sure make a great team!

Using the scale, evaluate how often the statements apply to the participant.

* He/she is enthusiastic.

* He/she is opinionated.

* He/she often looks stressed while talking.

* He/she is warm and friendly.

* He/she is rebellious.

* He/she points a finger in an accusatory way while talking.

* He/she often withdraws from uncomfortable situations.

* He/she is supportive of others' success.

* He/she is impulsive.

* He/she maintains direct eye contact.

* He/she reacts emotionally to stressful situations.

* He/she is concerned for others.

* He/she is analytical.

* He/she makes decisions based on facts.

* He/she often smiles or laughs.

* He/she tends to give excuses.

* He/she is critical.

* He/she keeps poor eye contact while talking.