Achievement - 360 Degree Feedback Survey Sample #10

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.


  • Demonstrates a well-organized and timely approach to achieve desired results
  • Schedules time for self and others to optimize high priority and long term actions. Monitors progress towards business goals.
  • Follows-up and takes action when goals are not met to ensure better results in the future.
  • Makes a plan for getting things done and drives execution of the strategic plan, actively supporting or leading initiatives to closure.
  • Completes work to a high technical standard
If [Participant Name] were to make improvements in Achievement, what are your suggestions for how he/she can improve this?

Continual Improvement

  • Promotes training and development opportunities to enhance job performance.
  • Looks for ways to expand and learn new job skills.
  • Encourages an employee culture of continuous improvement to seek out better ways of doing things.
  • Analyzes processes to determine areas for improvement.
  • Open to the suggestions from others.
If [Participant Name] were to make improvements in Continual Improvement, what are your suggestions for how he/she can improve this?


  • Open to the suggestions of others.
  • Shares past experiences with others as learning opportunities.
  • Is easy to approach with ideas and opinions.
  • Looks to others for input.
  • Asks others for their ideas and opinions.
If [Participant Name] were to make improvements in Feedback, what are your suggestions for how he/she can improve this?

Supervisory Skills

  • Is aware of the unique strengths of each employee.
  • Maintains good working relationships with employees.
  • Encourages employees to achieve their full potential.
  • Resolves personnel problems quickly and effectively.
  • Promotes teamwork and cooperation within the department.
If [Participant Name] were to make improvements in Supervisory Skills, what are your suggestions for how he/she can improve this?

Communication Skills

  • Has the confidence to communicate effectively to all levels (from CEO down) of the organization, external customers, suppliers, as well as the senior counsel of other companies.
  • Delivers influential presentations.
  • Coaches others and provides feedback on the use of different oral communication styles for different audiences
  • Presents issues, ideas, and strategy concisely and clearly.
  • Checks for understanding throughout conversations or group presentations/discussions
If [Participant Name] were to make improvements in Communication Skills, 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.