Accountability - 360 Degree Feedback Survey Sample #10

360 Feedback Survey

Questionnaires Measuring Accountability:
Survey 1 (4-point scale; Competency Comments)
Survey 2 (4-point scale; Competency Comments)
Survey 3 (5-point scale; Competency Comments)
Survey 4 (5-point scale; radio buttons)
Survey 5 (4-point scale; words)
Survey 6 (4-point scale; words)
Survey 7 (5-point scale; competency comments; N/A)
Survey 8 (3-point scale; Agree/Disagree words; N/A)
Survey 9 (3-point scale; Strength/Development; N/A)
Survey 10 (Comment boxes only)
Survey 11 (Single rating per competency)
Survey 12 (Slide-bar scale)

Thank you for providing feedback for the recipient above. As you respond, please draw on your first-hand experience with this individual in the past 12 months. Rate each item using the scale shown. If you don't feel you have enough first-hand information to rate a certain item, please choose the Not Applicable option. Comments can be very helpful; at a minimum where you give a particularly high or low rating, please share your reasons in the comment section for that competency. Your responses will be compiled with feedback from others and presented to the recipient to help guide their ongoing development.

Partially completed forms can be saved by using the Save/Still Working button at the bottom of the page. You may return at a later time to complete/edit the form. Your saved responses will be shown each time you re-visit the feedback form. When you are certain that you have completed your responses and will be not making any changes, click the Complete button.


  • Encourages others to adopt new procedures.
  • Open to the perspectives/viewpoints of others.
  • Willing to try new ideas.
  • Effective in incorporating new ideas.
  • Works effectively during periods of change.
If [Participant Name] were to make improvements in Flexibility, what are your suggestions for how he/she can improve this?


  • Implements and facilitates controls and processes that maintain the integrity of the organization.
  • Defines roles, rights, and responsibilities of employees.
  • Tackles issues head on and finds solutions.
  • Accepts accountability for their actions and results.
  • Takes ownership of mistakes and learns from them.
If [Participant Name] were to make improvements in Accountability, what are your suggestions for how he/she can improve this?

Emotional Intelligence

  • Is able to control their own emotions.
  • Accurately perceives the emotional reactions of others.
  • Is able to express themselves clearly.
  • Is able to manage their own emotions.
  • Helps to make decisions and solve problems using knowledge about how others will react in certain situations.
If [Participant Name] were to make improvements in Emotional Intelligence, what are your suggestions for how he/she can improve this?

Persuasion and Influence

  • Attempts to persuade others rather than simply control them.
  • Has excellent influencing/negotiating skills.
  • Able to express own goals and needs.
  • Understanding what others need.
  • Develops a good rapport with others.
If [Participant Name] were to make improvements in Persuasion and Influence, what are your suggestions for how he/she can improve this?

Developing Others

  • Tries to ensure employees are ready to move to the next level.
  • Creates a work environment that fosters positive feedback to employees.
  • Assesses employees' developmental needs.
  • Creates opportunities for professional development.
  • Develops employees by offering and encouraging them to take on new or additional responsibilities.
If [Participant Name] were to make improvements in Developing Others, what are your suggestions for how he/she can improve this?
Overall, please rate the effectiveness of [Participant Name Here].


Areas for Development

Please give any final comments or suggestions for [Participant Name Here]'s assessment.