Company- 360 Degree Feedback Survey Sample #11

360 Feedback Survey

Assessments 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)

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.


What does Company mean?
It means that ...
  • You understand the use of [Company] products and services.
  • You impress upon others the important aspects of [Company].
  • You understand how decisions impact other business units beyond your immediate department of work group.
  • You express loyalty and dedication to [Company] in interactions with others.
  • You understand the "basics" as to how [Company] functions/operates.

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


What does Vision mean?
It means that ...
  • You demonstrate consistency between words and actions
  • You persuade others to follow the Company's vision.
  • You create a positive vision of the future for the Company.
  • You create a common vision for others.
  • You understand the vision of the Company and promote it ahead of any self-interests.

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


What does Management mean?
It means that ...
  • You keep staff informed about what is happening in the company
  • You make others feel enthusiastic about your work
  • You take responsibility for things that go wrong
  • You set an example for others to follow
  • You delegate tasks effectively

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

Empowering Others

What does Empowering Others mean?
It means that ...
  • You encourage others to obtain necessary skills and training.
  • You encourage employees to solve problems on your own.
  • You set clear goals for others to accomplish.
  • You avoid micromanaging your employees.
  • You provide support and resources needed to accomplish goals.

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


What does Punctuality mean?
It means that ...
  • You avoid making personal phone calls during working hours.
  • You invoice clients on a timely basis.
  • You start the workday when scheduled.
  • You conduct appointments at scheduled start time.
  • You maintain an efficient schedule of activities.

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

Areas for Development

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