Communication - 360 Degree Feedback Survey Sample #10

360 Feedback Survey

Questionnaires Measuring Communication:
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.

Communication Skills

  • Is an effective communicator
  • Presents issues, ideas, and strategy concisely and clearly.
  • Delivers influential presentations.
  • Chooses the communication medium (ie. email, voice mail, memo, project document) that reflects the needs of the content. (ie. urgency, confidentiality, content scope)
  • Able to demonstrate persuasiveness in pursuit of objectives.
If [Participant Name] were to make improvements in Communication Skills, what are your suggestions for how he/she can improve this?

Emotional Intelligence

  • Helps employees to resolve conflicts, communicate clearly, and work together to solve problems.
  • Is able to control their own emotions.
  • Is attentive to emotional cues and interprets others' feelings correctly.
  • Accurately perceives the emotional reactions of others.
  • Helps to make decisions and solve problems using knowledge about how others will react in certain situations.
If [Participant Name] were to make improvements in Emotional Intelligence, what are your suggestions for how he/she can improve this?


  • Keeps themselves and others focused on constant improvement.
  • Can be counted on to add value wherever they are involved.
  • Produces high quality work.
  • Demonstrates the functional or technical skills necessary to do their job.
  • Demonstrates the analytical skills to do their job.
If [Participant Name] were to make improvements in Excellence, what are your suggestions for how he/she can improve this?


  • Sets high personal standards of performance.
  • Completes assigned work tasks.
  • Sets a good example
  • ...takes personal responsibility for results.
  • Holds herself / himself accountable to goals / objectives
If [Participant Name] were to make improvements in Responsible, what are your suggestions for how he/she can improve this?

Organizational Fluency

  • Effective in communicating with others within the organization.
  • Adept at navigating within the culture of the department.
  • Understands departmental policies and procedures.
  • Able to explain departmental policies and procedures to others.
  • Gets things done through the department.
If [Participant Name] were to make improvements in Organizational Fluency, 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.