Achievement - 360 Degree Feedback Survey Sample #9

360 Feedback Survey

Questionnaires Measuring Achievement:
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.

Sample Result Document:
Sample Results
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.


Definite Strength Meets Standards Needs Development N/A
  1. Sets ambitious standards of performance.
  1. Works at a quick pace to complete a high volume of work.
  1. Uses established goals and performance measures to keep track of performance.
  1. Follows-up and takes action when goals are not met to ensure better results in the future.
  1. Schedules time for self and others to optimize high priority and long term actions. Monitors progress towards business goals.

Communication Skills

Definite Strength Meets Standards Needs Development N/A
  1. Able to deliver presentations.
  1. An effective listener who is responsive to information needs.
  1. Chooses the communication medium (ie. email, voice mail, memo, project document) that reflects the needs of the content. (ie. urgency, confidentiality, content scope)
  1. Listens to others' points of view with an open mind
  1. Delivers information in a clear, concise, and logical manner.


Definite Strength Meets Standards Needs Development N/A
  1. Encourages others to adopt new procedures.
  1. Identifies new opportunities to achieve goals
  1. Adapts to circumstances as needed.
  1. Works effectively during periods of change.
  1. Adapts to new organizational structures, policies, or procedures.

Bias for Action

Definite Strength Meets Standards Needs Development N/A
  1. Completes work on time
  1. Completes a large volume of work.
  1. Coach others to foster an environment which can adapt quickly and willingly to rapid change.
  1. Seeks and utilizes opportunities for continuous learning and self-development.
  1. Encourages risk taking and experimentation to improve performance

Emotional Intelligence

Definite Strength Meets Standards Needs Development N/A
  1. Able to understand others' points of view.
  1. Helps employees to resolve conflicts, communicate clearly, and work together to solve problems.
  1. Is attentive to emotional cues and interprets others' feelings correctly.
  1. Is able to express themselves clearly.
  1. Accurately perceives the emotional reactions of others.

Administrative Skill

Definite Strength Meets Standards Needs Development N/A
  1. High attention to detail.
  1. Enthusiastic about taking on challenging projects.
  1. Strong organizational skills to keep the workspace and department in order
  1. Has strong technical/computer skills.
  1. Implements and uses performance measures.

Time Management

Definite Strength Meets Standards Needs Development N/A
  1. Uses agendas when chairing or facilitating meetings.
  1. Completes tasks ahead of schedule.
  1. Prioritizes new tasks according to their relative importance.
  1. Sets a good balance between work and family life.
  1. Avoids distractions in the workplace.


Definite Strength Meets Standards Needs Development N/A
  1. Sets a good example
  1. Completes assigned work tasks.
  1. Sets a good example.
  1. Sets high personal standards of performance.
  1. Behavior is ethical and honest.


Definite Strength Meets Standards Needs Development N/A
  1. Understands the expectations of other parties in the negotiation.
  1. Maintains communication channels between parties in the negotiation.
  1. Conducts necessary preparations before engaging in negotiations.
  1. Stays calm and focuses on the core issues to be discussed.
  1. Maintains good interpersonal relationships with representatives from the other party.

Organizational Fluency

Definite Strength Meets Standards Needs Development N/A
  1. Able to explain departmental policies and procedures to others.
  1. Understands the current organizational culture.
  1. Able to use corporate politics to advance department objectives.
  1. Is aware of other organizational cultures to compare/contrast with the current organizational culture.
  1. Anticipates problems that may affect the department.

  1. Overall, please rate the effectiveness of [Participant Name Here].

  2. Strengths

  3. Areas for Development

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