This review centers on both outcomes and behaviors. Please reflect on how you or your colleague embody organizational values while delivering results.
Full Name
Job Title
Department/Team
Review Period Start Date
Review Period End Date
Type of Review
Self-Assessment
Manager Review
360 Peer Review
Skip-Level Review
Project-Based Review
Primary Goals for This Review Period
Rate how consistently the employee demonstrated each organizational value. Provide evidence for ratings below 'Consistently Demonstrated'.
Values Demonstration
Rarely | Sometimes | Often | Consistently | Exemplary | |
|---|---|---|---|---|---|
Integrity & Transparency | |||||
Respect & Inclusion | |||||
Collaboration & Teamwork | |||||
Accountability & Ownership | |||||
Innovation & Learning | |||||
Compassion & Empathy |
Example Where Integrity Was Tested
Did the employee champion inclusion this period?
Assess proficiency in key competencies critical to our mission. Provide concrete examples for ratings of 'Developing' or below.
Leadership & Influence
Below Expectations | Developing | Meets Expectations | Exceeds Expectations | Role Model | |
|---|---|---|---|---|---|
Inspires and motivates others | |||||
Makes decisions with a people-first lens | |||||
Coaches and develops peers | |||||
Navigates ambiguity with calm confidence |
Stakeholder Engagement
Below Expectations | Developing | Meets Expectations | Exceeds Expectations | Role Model | |
|---|---|---|---|---|---|
Builds trust with diverse stakeholders | |||||
Communicates with clarity and empathy | |||||
Manages conflict constructively | |||||
Advocates for under-represented voices |
Which competency showed the most growth?
Leadership & Influence
Stakeholder Engagement
Strategic Thinking
Operational Excellence
Learning Agility
Evidence of Growth
Evaluate achievements while considering the methods used. Ethical shortcuts erode long-term value.
Key Results & How They Were Achieved
Goal/Metric | Target | Actual Outcome | Completion Date | Method Used | Stakeholder Sentiment | |
|---|---|---|---|---|---|---|
Launch community health program | 500 beneficiaries | 485 beneficiaries | 3/15/2025 | Collaborative | ||
Reduce process cycle time | 20% reduction | 32% reduction | 2/28/2025 | Data-driven | ||
Were any results achieved via practices that compromised our values?
Growth mindset is a core value. Identify learning achievements and future needs.
Learning Activities Undertaken
Internal workshops
External conferences
Online courses
Peer mentoring
Stretch assignments
Volunteer projects
Self-study
None
Most Impactful Learning Experience
Rate Learning Transfer to Job
Primary Development Need for Next Period
Strategic thinking
Digital fluency
Cross-cultural competence
Resilience & well-being
Storytelling & influence
Financial acumen
Other
Support Needed from Organization
Sustainable performance requires balance. Assess workload, stress, and support systems.
How do you feel about your workload?
Have you experienced signs of burnout this period?
Frequency of Recovery Breaks
Daily
Weekly
Monthly
Rarely
Never
What practices help you stay resilient?
Organizational Support for Well-Being
Very Poor
Poor
Neutral
Good
Excellent
Aggregate feedback from peers, direct reports, and partners.
Number of Peer Feedback Responses Received
Top Strengths Mentioned by Others
Most Frequent Development Theme from Others
Any surprising feedback?
Encouraging transparent reporting of concerns strengthens organizational integrity.
Did you witness or experience an ethical dilemma this period?
Do you feel safe to speak up without retaliation?
I am aware of confidential reporting channels
Trust in Leadership to Act on Concerns
No trust
Low trust
Moderate trust
High trust
Complete trust
Assess contribution to innovation while respecting risk and ethics.
New Ideas Proposed
Did any innovation face resistance due to values conflicts?
Rate Innovation Process Support
Suggestion for Improvement
Evaluate how the employee shapes team norms and psychological safety.
Team Culture Behaviors
Never | Rarely | Sometimes | Often | Always | |
|---|---|---|---|---|---|
Celebrates others' successes | |||||
Shares failures to foster learning | |||||
Includes quiet voices in meetings | |||||
Challenges respectfully | |||||
Mentors newcomers |
Example of Psychological Safety in Action
Has the employee received a team culture award or shout-out?
For mission-driven organizations, external engagement amplifies impact.
External Engagement Activities
Volunteering
Pro-bono consulting
Public speaking
Policy advocacy
Community organizing
Board service
None
Impact Story
Did you represent the organization in external forums?
How do external stakeholders perceive our values?
Assess how well managers remove barriers and provide resources for values-aligned performance.
Manager Enablement
Strongly Disagree | Disagree | Neutral | Agree | Strongly Agree | |
|---|---|---|---|---|---|
Provides timely feedback | |||||
Removes bureaucratic obstacles | |||||
Advocates for resources | |||||
Models organizational values | |||||
Coaches rather than directs |
Best Manager Interaction This Period
Would you recommend your manager to others?
Set forward-looking goals that balance ambition with well-being and ethics.
Top 3 Goals for Next Period
Confidence Level in Achieving Goals
Low - Need significant support
Moderate - Some barriers exist
High - Clear path forward
Very High - Fully equipped
Support Needed from Organization
Training budget
Mentor assignment
Time allocation
Tool access
Process changes
Team expansion
None
Would a 4-day workweek increase your sustainable productivity?
Conclude with honest reflections and commitments.
Proudest Values-Aligned Moment This Period
Biggest Lesson Learned
Overall Performance Rating
Needs Support
Developing
Strong
Exceptional
Transformational
I am committed to acting on feedback received
Signature of Reviewee
Signature of Reviewer
Review Completion Date
Analysis for Values & Competencies Performance Review Form
Important Note: This analysis provides strategic insights to help you get the most from your form's submission data for powerful follow-up actions and better outcomes. Please remove this content before publishing the form to the public.
This Values & Competencies Performance Review Form is purpose-built for mission-driven organizations that equate “how” results are achieved with the results themselves. The form’s architecture deliberately embeds values-based questions inside every performance dimension—something rarely seen in traditional, output-only reviews. By forcing reviewers to evidence behaviors alongside outcomes, the design protects long-term culture from ethical shortcuts and reinforces psychological safety.
Strengths include the progressive disclosure logic (yes/no gates with adaptive follow-ups), the balanced use of qualitative and quantitative inputs, and the explicit separation of well-being, social impact, and ethical dilemmas into their own sections. These choices reduce cognitive load while surfacing data that conventional HRIS platforms typically ignore. The matrix-style ratings keep the survey compact yet granular enough for statistical analysis, while open text boxes with smart placeholders nudge reviewers toward concrete, situation-based evidence.
Full Name
The mandatory open field anchors every subsequent record to a single identity, preventing duplicate or orphaned reviews. Its placement at the top of the form accelerates onboarding for reviewers who may be completing multiple assessments in one session.
Data quality is straightforward: plain-text validation plus uniqueness checks against the HRIS. Privacy is mitigated because the form is internally routed; no external third party sees raw identifiers. From a UX perspective, single-line text keeps the perceived effort low, increasing completion likelihood for the very first question.
Job Title & Department/Team
Collecting both pieces enables cross-functional benchmarking of values demonstration—crucial for matrix organizations where culture must persist beyond silos. Together they power analytics dashboards that reveal whether certain teams consistently rate higher on inclusion or ethical behavior, guiding targeted interventions.
Keeping the fields free-text rather than pick-lists future-proofs the form for reorganizations or new roles, but requires downstream data cleaning. The form could be strengthened with a dynamic lookup that still allows free-text overrides, balancing standardization with flexibility.
Review Period Start/End Dates
Explicit date capture normalizes reviews across rolling hiring cycles, ensuring comparability when measuring quarter-over-quarter culture shifts. The date-picker UI reduces formatting errors, while the bounded period (≤ 12 months recommended in help text) prevents reviewers from selecting multi-year spans that would dilute insights.
These fields also feed automated reminders and compliance reports; regulators increasingly ask for proof that evaluations occur at least annually. Mandatory status is therefore both a governance and a data-integrity safeguard.
Type of Review
This single-choice gate determines which conditional sections are shown later (e.g., 360 feedback summary). By capturing the review type up front, the form can branch logic dynamically, shortening the experience for self-assessments while expanding it for 360 or skip-level reviews.
Analytics benefit because weightings can be applied—peer reviews might count 30% toward a final score, whereas self-assessments are purely developmental. Making this mandatory prevents orphaned records that lack context for interpretation.
Primary Goals for This Review Period
Requiring reviewers to restate pre-agreed goals at the outset forces a re-validation conversation between manager and employee. This single step reduces “goal drift” and increases fairness because raters must confront what was originally promised.
The open text format encourages specificity (e.g., “Launch literacy program in Q2” vs. generic “improve service”). NLP tools can later extract entities and map them to strategic pillars, giving HR a direct line-of-sight from individual contributions to mission outcomes.
Which Competency Showed the Most Growth?
Mandatory single-choice here operationalizes a growth-mindset culture. It signals that progression, not perfection, is the currency of the organization. When aggregated, these data reveal which enterprise-wide initiatives actually moved the needle, offering ROI evidence for learning budgets.
Because the list is finite and mutually exclusive, the field is analytics-ready for cohort tracking without further cleansing. UX friction is minimal because the question is asked immediately after the detailed matrix ratings, so the rater’s mental model is still fresh.
Top 3 Goals for Next Period
Forward-looking mandatory goals close the loop between review and performance planning, eliminating the common “review and forget” syndrome. The triad structure prevents goal bloat while still covering personal development, values demonstration, and business results.
Because the field is free-text, employees can embed SMART criteria directly, increasing the likelihood that next year’s review will find clear evidence of achievement. HR can run similarity clustering to identify common capability gaps across teams, informing training calendars.
I am Committed to Acting on Feedback Received
This mandatory yes/no attestation converts feedback into a psychological contract. Research shows that public commitment increases follow-through by over 30%. The binary nature removes ambiguity for managers when tracking post-review actions.
From a compliance standpoint, the field provides audit evidence that employees were presented with feedback and accepted it, protecting the organization in disputes. UX-wise, the yes/no toggle is faster than a signature, yet the subsequent signature fields still supply legal weight.
Review Completion Date
A mandatory date stamp enables HR to enforce deadlines, trigger escalations, and maintain an authoritative record for labor inspections. When paired with the review-type field, it supports metrics like “median days from period-end to review closure,” a key indicator of managerial diligence.
Using a date-picker rather than text reduces formatting variance, facilitating direct integration into HRIS workflows without middleware parsing.
Mandatory Question Analysis for Values & Competencies Performance Review Form
Important Note: This analysis provides strategic insights to help you get the most from your form's submission data for powerful follow-up actions and better outcomes. Please remove this content before publishing the form to the public.
Question: Full Name
The employee’s legal name is the primary key linking this review to HRIS records, payroll, and compliance filings. Without it, downstream processes such as promotion letters or visa renewals cannot proceed. Mandatory capture at the start also prevents anonymous submissions that would undermine audit trails.
Question: Job Title
Job title contextualizes performance expectations; a Program Manager is held to different behavioral standards than a Lab Technician. Making this field mandatory ensures analytics compare apples to apples when benchmarking values demonstration across roles. It also future-proofs the record for reorganizations where titles may change.
Question: Department/Team
Culture often varies by micro-climate within large organizations. Mandatory team identification enables targeted interventions—if the Finance team consistently scores lower on inclusion, leadership can launch specific dialogues. Omitting this field would fragment data and obscure systemic issues.
Question: Review Period Start Date & End Date
These two mandatory dates bound the evaluation window, ensuring consistency when comparing employees hired at different times. They also satisfy regulatory requirements for annual reviews and power automated reminders. Without them, trend analyses and year-over-year dashboards become unreliable.
Question: Type of Review
The review type drives branching logic and weightings in aggregate scoring. Making it mandatory prevents data misclassification (e.g., treating a 360 review as a self-assessment), which would corrupt culture analytics and misinform promotion decisions.
Question: Primary Goals for This Review Period
Restating agreed goals up front anchors the review in objective criteria, reducing recency bias. Mandatory capture guarantees that raters confront whether goals were met, creating a fairer process and defensible documentation for merit decisions.
Question: Which Competency Showed the Most Growth?
This single-choice field operationalizes the organization’s growth mindset value. Mandatory selection ensures every review celebrates progress, not just gaps. Aggregated data guide L&D investment toward competencies with the highest realized ROI.
Question: Top 3 Goals for Next Period
Requiring forward-looking goals converts the review from a rear-view mirror into a performance contract. It eliminates the common “review and forget” cycle and gives managers a clear baseline for next period’s evaluation. The triad structure balances ambition with focus.
Question: I am Committed to Acting on Feedback Received
This attestation transforms feedback into a psychological contract. Mandatory acceptance increases follow-through rates and provides legal evidence that feedback was delivered and acknowledged, protecting both employee and organization in disputes.
Question: Review Completion Date
A mandatory date stamp enforces deadline compliance and feeds culture-speed metrics such as “median days to close.” It also serves as an authoritative record for labor inspections, ensuring the organization can prove timely performance conversations occurred.
The current mandatory set strikes an effective balance between data integrity and user burden: only 11 of 60+ fields are required. All chosen fields are either legal identifiers, key analytics dimensions, or forward-looking commitments—items that lose value if optional. To further optimize, consider making the “Values Demonstration” matrix mandatory only when any rating falls below “Often,” triggering an evidence requirement. This conditional approach would preserve rich data while reducing fatigue for consistently high performers.
Additionally, introduce real-time progress indicators (“7 of 11 mandatory items complete”) to set clear expectations without overwhelming reviewers. For global rollouts, localize the mandatory labels and add brief help text explaining why each field matters; transparency increases compliance more effectively than red asterisks alone.