Company- 360 Degree Feedback Survey Sample #8

Questionnaires Measuring Company:
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)

You have been selected to provide feedback for the manager listed above. Your feedback is an important part of 's leadership development process. This tool is intended to gather broad feedback in the core competencies and role responsibilities that are important for the on-going success of our organization.

In responding to the assessment form, please think about your experiences working with this individual during the last six to twelve months. Your responses will be merged with other people's feedback and presented to to guide them in their on-going development. Comments will be shared anonymously, as written, with the manager.

Sample Result Document:
Sample Results
Method of use: As part of the review process, managers will receive feedback from peers and staff. It is recognized that not all participants will be able to assess an individual's performance in all areas. The feedback received will be utilized as input to the manager's performance and on-going development plan.

You may sign out at any time by pressing the Save button at the end of the form and then closing your browser. You may return later to pick up where you left off. When you are done, press the Complete button.

When clicking your selection below, try to best fit the manager's actual behaviors to the scale provided.

If you are not sure, or unable to assess, select "Not Applicable" (N/A) option.

Please complete your response by .


Agree Unsure Disagree N/A
  1. Understands the "basics" as to how [Company] functions/operates.
  1. Follows existing procedures and processes.
  1. Expresses loyalty and dedication to [Company] in interactions with others.
  1. Impresses upon others the important aspects of [Company].
  1. Understands how decisions impact other business units beyond their immediate department of work group.

Strategic Focus

Agree Unsure Disagree N/A
  1. Able to decline a poor strategy by proposing alternate strategies.
  1. Understands their role within the organization.
  1. Looks for opportunities to enhance contributions to the bottom line.
  1. Communicates goals and objectives to employees.
  1. Focuses attention on treating the causes of problems rather than simply addressing the symptoms.

Bias for Action

Agree Unsure Disagree N/A
  1. Coach others to foster an environment which can adapt quickly and willingly to rapid change.
  1. Conveys a sense of urgency about addressing problems and opportunities
  1. Displays high energy and enthusiasm on consistent basis.
  1. Motivates others to achieve or exceed goals
  1. Projects a "can-do" attitude when interfacing with peers, subordinates and customers(especially during difficult and challenging times).

Continual Learning

Agree Unsure Disagree N/A
  1. Pursues professional development opportunities when they arise.
  1. Builds on their strengths while addressing their weaknesses.
  1. Is open to new ideas and concepts.
  1. Sets relevant learning objectives and goals.
  1. Participates in regular training offered.


Agree Unsure Disagree N/A
  1. Contributes to a positive and fun work environment.
  1. Treats all people fairly and with respect.
  1. Works to eliminate unnecessary work or barriers that get in others' way.
  1. Is gracious and professional in their interactions with others.
  1. Builds open and trusting relationships.

Persuasion and Influence

Agree Unsure Disagree N/A
  1. Able to express own goals and needs.
  1. Communicates effectively with others.
  1. Persuades others to consider alternative points of view.
  1. Ensures stakeholders are involved in the decision making process.
  1. Has excellent influencing/negotiating skills.

Managing Risk

Agree Unsure Disagree N/A
  1. Develops policies to address risk situations in the workplace.
  1. Seeks to retain the best and brightest employees.
  1. Maintains open communication with other departments.
  1. Rewards innovative experiments to try new ideas.
  1. Avoids maintaining the status quo (or standard operating procedures) when addressing new and influential situations.

Co-worker Development

Agree Unsure Disagree N/A
  1. Gives others development opportunities through project assignments and increased job responsibilities
  1. Provides ongoing feedback to co-workers on their development progress
  1. Takes immediate action on poor performance
  1. Adapts coaching and mentoring approach to meet the style or needs of individuals
  1. Sets and clearly communicates expectations, performance goals, and measurements to others


Agree Unsure Disagree N/A
  1. Says "thank you" to show appreciation for work of others.
  1. Recognizes the abilities and skills of self and others
  1. Offers recognition in a timely manner.
  1. Compliments other people when they do good work
  1. Is sincerely interested in the suggestions of co-workers

  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.