Clarity - 360 Degree Feedback Survey Sample #11

360 Feedback Survey

Questionnaires Measuring Clarity:
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.

To what extent does [Participant Name] exhibit the following ...

SELECT the rating that best reflects the employee's performance in the areas listed.


What does Clarity mean?
It means that ...
  • You avoid creating ambiguity or mixed messages.
  • You make sure goals and objectives are clearly and thoroughly explained and understood.
  • You communicate ideas and facts clearly and effectively in writing.
  • You check details thoroughly.
  • You attend to the important details of a job or task.

To what extent does this person exhibit Clarity?
Select from one of the ratings below.

Professional Development

What does Professional Development mean?
It means that ...
  • You allow employees to fully participate in employee training and professional development.
  • You demonstrate enthusiasm and a willingness to learn new skills and knowledge
  • You are contributing fully to the extent of your skills
  • You seek opportunities for continuous learning.
  • You keep yourself up-to-date of technical/professional issues

To what extent does this person exhibit Professional Development?
Select from one of the ratings below.


What does Responsible mean?
It means that ...
  • You complete assigned work tasks.
  • You are responsible for setting the vision of the department.
  • You set a good example
  • You are a person others can trust.
  • You act as a resource without removing individual responsibility.

To what extent does this person exhibit Responsible?
Select from one of the ratings below.


What does Teamwork mean?
It means that ...
  • You communicate well with team members.
  • You coach team members to work toward a common goal.
  • You encourage open communication
  • You identify and resolves conflicts within the team to increase team effectiveness
  • You contribute to and supports team decision-making process

To what extent does this person exhibit Teamwork?
Select from one of the ratings below.

Time Management

What does Time Management mean?
It means that ...
  • You do not procrastinate.
  • You complete tasks ahead of schedule.
  • You prioritize tasks to identify immediate and long-term objectives.
  • You leave time in the schedule for unplanned contingencies.
  • You keep and maintain a To-Do list.

To what extent does this person exhibit Time Management?
Select from one of the ratings below.

Areas for Development

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