Attitude - 360 Degree Feedback Survey Sample #10

360 Feedback Survey

Questionnaires Measuring Attitude:
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.


  • Treats all people fairly and with respect.
  • Is gracious and professional in their interactions with others.
  • Shows by their actions that they trust in the positive intentions of others.
  • Contributes to a positive work environment.
  • Contributes to a positive and fun work environment.
If [Participant Name] were to make improvements in Attitude, what are your suggestions for how he/she can improve this?


  • Analyzes issues and reduces them to their component parts.
  • Implements data validation techniques and methods.
  • Asks the "right" questions to size up or evaluate situations.
  • Identifies problems and issues needing resolution.
  • Identifies the root cause of a problem.
If [Participant Name] were to make improvements in Analytical, what are your suggestions for how he/she can improve this?


  • Willingly shares information and expertise; sought out as resource by others
  • Demonstrates mastery of the technical competencies required in his/her work.
  • Is naturally sought out by people outside his/her particular area for advice and opinion on a broad range of matters - not necessarily solely legal advice.
  • Keeps current with technical advances within his/her professional discipline; embraces and applies new techniques and practices
  • Seeks information from others as needed.
If [Participant Name] were to make improvements in Technical, what are your suggestions for how he/she can improve this?

Interpersonal Skills

  • Uses knowledge and charisma rather than position, power, or coercion to influence others
  • Expresses appreciation of other's work.
  • Able to work with individuals at all levels of the Company.
  • Values the opinions of others.
  • Strives for win/win solutions
If [Participant Name] were to make improvements in Interpersonal Skills, what are your suggestions for how he/she can improve this?


  • Able to look ahead (beyond the present) when addressing the work/needs of the department.
  • Anticipates potential challenges, develops plan to overcome them and then carries out the plan.
  • Anticipates obstacles and ways to overcome them.
  • Makes plans and follows through.
  • Works in an organized manner
If [Participant Name] were to make improvements in Planning, 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.