Communication - 360 Degree Feedback Survey Sample #11

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.

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

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

Communication Skills

What does Communication Skills mean?
It means that ...
  • You an effective listener who is responsive to information needs.
  • You give clear and convincing presentations.
  • You choose the communication medium (ie. email, voice mail, memo, project document) that reflects the needs of the content. (ie. urgency, confidentiality, content scope)
  • You communicate effectively with all levels of the organization.
  • You address issues of key importance to stakeholders.

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


What does Integrity mean?
It means that ...
  • You follow tasks to completion.
  • You protect the integrity and confidentiality of information
  • You establish relationships of trust, honesty, fairness, and integrity.
  • You accept responsibility for mistakes.
  • You foster a high standard of ethics and integrity.

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

Juggling Multiple Responsibilities

What does Juggling Multiple Responsibilities mean?
It means that ...
  • You observe, analyze, and respond to merchandise needs while serving customers and accomplishing operational tasks.
  • You assess current capabilities before committing to new requests from customers.
  • You bounce back from daily crisis, disappointments and frustrations.
  • You maintain self-confidence and a positive mental attitude while facing challenging peaks and valleys of activities.
  • You integrate developing others with driving sales, serving customers, merchandising, performing operational procedures, and maintaining an appealing store environment.

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


What does Clarity mean?
It means that ...
  • You make sure goals and objectives are clearly and thoroughly explained and understood.
  • You clarify problems and your causes to help employees correct them.
  • You attend to the important details of a job or task.
  • You check details thoroughly.
  • You communicate ideas and facts clearly and effectively in writing.

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

Co-worker Development

What does Co-worker Development mean?
It means that ...
  • You set and clearly communicate expectations, performance goals, and measurements to others
  • You take immediate action on poor performance
  • You give others development opportunities through project assignments and increased job responsibilities
  • You provide ongoing feedback to co-workers on your development progress
  • You adapt coaching and mentoring approach to meet the style or needs of individuals

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

Areas for Development

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