Collaboration- 360 Degree Feedback Survey Sample #10

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.

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.


  • Is a trustworthy and credible partner.
  • Builds consensus among team members.
  • Displays a high degree of trust and credibility.
  • Works to create innovative ideas from the collaboration with others.
  • Works with others to develop strategies to identify needs and priorities.
If [Participant Name] were to make improvements in Collaboration, what are your suggestions for how he/she can improve this?


  • Actively seeks feedback from others.
  • Is visible and approachable.
  • Looks to others for input.
  • Open to the suggestions of others.
  • Shares past experiences with others as learning opportunities.
If [Participant Name] were to make improvements in Feedback, what are your suggestions for how he/she can improve this?


  • Assigns tasks to create learning opportunities for the employees.
  • Delegates tasks, responsibilities, and accountability as appropriate to the level of employee.
  • Encourages and empowers subordinates to use initiative in achieving goals and objectives.
  • Allows subordinates to use their own methods and procedures.
  • Entrusts subordinates with important tasks.
If [Participant Name] were to make improvements in Delegation, what are your suggestions for how he/she can improve this?

Time Management

  • Leaves time in the schedule for unplanned contingencies.
  • Sets a good balance between work and family life.
  • Deals effectively with interruptions.
  • Does not become flustered by deadlines and timelines.
  • Uses agendas when chairing or facilitating meetings.
If [Participant Name] were to make improvements in Time Management, what are your suggestions for how he/she can improve this?


  • Reinforces and rewards employees for accomplishing necessary goals.
  • Says "thank you" to show appreciation for work of others.
  • Recognizes individuals for a specific outstanding achievement.
  • Recognizes team members who offer a significant contribution to a project.
  • Finds opportunities to recognize others.
If [Participant Name] were to make improvements in Recognition, 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.