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.

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. Demonstrates a well-organized and timely approach to achieve desired results
  1. Makes a plan for getting things done and drives execution of the strategic plan, actively supporting or leading initiatives to closure.
  1. Completes work to a high technical standard
  1. Follows-up and takes action when goals are not met to ensure better results in the future.
  1. Systematically works to improve the organization

Communication Skills

Definite Strength Meets Standards Needs Development N/A
  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. An effective listener who is responsive to information needs.
  1. Delivers influential presentations.
  1. Communicates effectively with colleagues and customers
  1. Deals with difficult situations calmly and confidently.


Definite Strength Meets Standards Needs Development N/A
  1. Identifies new opportunities to achieve goals
  1. Works effectively during periods of change.
  1. Acts decisively in frequently changing and uncertain environment.
  1. Willing to try new ideas.
  1. Is open to alternative ways to accomplish goals

Bias for Action

Definite Strength Meets Standards Needs Development N/A
  1. Motivates others to achieve or exceed goals
  1. Projects a "can-do" attitude when interfacing with peers, subordinates and customers(especially during difficult and challenging times).
  1. Completes a large volume of work.
  1. Completes work on time
  1. Encourages risk taking and experimentation to improve performance

Emotional Intelligence

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

Administrative Skill

Definite Strength Meets Standards Needs Development N/A
  1. Accurately implements contract provisions.
  1. Able to develop, justify and present a budget.
  1. Strong organizational skills to keep the workspace and department in order
  1. Completes reports on-time.
  1. High attention to detail.

Time Management

Definite Strength Meets Standards Needs Development N/A
  1. Does not procrastinate.
  1. Prioritizes new tasks according to their relative importance.
  1. Sets a good balance between work and family life.
  1. Deals effectively with interruptions.
  1. Sets clearly defined goals.


Definite Strength Meets Standards Needs Development N/A
  1. Acts as a resource without removing individual responsibility.
  1. Behavior is ethical and honest.
  1. Holds herself / himself accountable to goals / objectives
  1. Completes assigned work tasks.
  1. Is a person you can trust.


Definite Strength Meets Standards Needs Development N/A
  1. Able to say "no" when necessary to effectively execute business strategy and meet long-term objectives.
  1. Actively listens to conversations to be able to recall important details later.
  1. Able to adapt to changing situations.
  1. Able to influence others to accept certain positions.
  1. Establishes good working relationships with others.

Organizational Fluency

Definite Strength Meets Standards Needs Development N/A
  1. Understands the current organizational culture.
  1. Understands departmental policies and procedures.
  1. Anticipates problems that may affect the department.
  1. Able to deal with sensitive issues with tact and professionalism.
  1. Able to use corporate politics to advance department objectives.

  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.