Collaboration- 360 Degree Feedback Survey Sample #9

360 Feedback Survey

Assessments Measuring Collaboration:
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. Builds consensus among partners.
  1. Creates an environment that encourages information sharing.
  1. Encourages working together to achieve shared goals.
  1. Readily shares information with other group members.
  1. Defines shared goals with the committee members.


Definite Strength Meets Standards Needs Development N/A
  1. Conducts regular performance appraisals and feedback.
  1. Develops the skills and capabilities of others.
  1. Coaches employees in how to strengthen knowledge and skills to improve work performance.
  1. Meets regularly with employees to coach them on areas that will enhance their performance
  1. Addresses employee behavior problems effectively.


Definite Strength Meets Standards Needs Development N/A
  1. Willing to change ideas or perceptions based on new information or contrary evidence which is presented.
  1. Is flexible and open minded in dealing with others.
  1. Learns from personal experiences and/or mistakes.
  1. Works effectively in dynamic and changing work environments.
  1. Performs a wide range of tasks, responds to changes in direction and priorities and accepts new challenges, responsibilities, and assignments.

Passion To Learn

Definite Strength Meets Standards Needs Development N/A
  1. Enhances value to the company through additional training and development.
  1. Takes initiative for own learning and development.
  1. Exhibits willingness to upgrade skills through additional training and education.
  1. Enjoys learning new skills and techniques.
  1. Will participate in training classes even if offered outside of normal working hours.

Supervisory Skills

Definite Strength Meets Standards Needs Development N/A
  1. Provides constructive, ongoing feedback.
  1. Is aware of the unique strengths of each employee.
  1. Appropriately recognizes and rewards employees.
  1. Treats all staff equitably.
  1. Promotes teamwork and cooperation within the department.

Fiscal Management

Definite Strength Meets Standards Needs Development N/A
  1. Effectively manages appropriations, reporting, purchases, expenditures, payrolls, and staff.
  1. Develops budgets and plans for various programs and initiatives.
  1. Effective in using Company's resources.
  1. Monitors spending.
  1. Keeps excellent records for financial transparency.

  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.