Continual Improvement - 360 Degree Feedback Survey Sample #10

360 Feedback Survey

Questionnaires Measuring Continual Improvement:
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.

Continual Improvement

  • Analyzes processes to determine areas for improvement.
  • Looks for ways to improve work processes and procedures.
  • Looks for ways to expand and learn new job skills.
  • Searches for new methods, techniques, and processes that increase efficiency and reduce costs.
  • Promotes training and development opportunities to enhance job performance.
If [Participant Name] were to make improvements in Continual Improvement, what are your suggestions for how he/she can improve this?

Persuasion and Influence

  • Understanding what others need.
  • Develops a good rapport with others.
  • Persuades others to consider alternative points of view.
  • Has excellent influencing/negotiating skills.
  • Ensures stakeholders are involved in the decision making process.
If [Participant Name] were to make improvements in Persuasion and Influence, what are your suggestions for how he/she can improve this?


  • Defines the roles, responsibilities, required actions, and deadlines for team members.
  • Sets clear and reasonable expectations for others and follows through on their progress.
  • Allows employees to decide how they wish to complete the tasks.
  • Clearly defines duties and tasks to be completed.
  • Assigns tasks to create learning opportunities for the employees.
If [Participant Name] were to make improvements in Delegation, what are your suggestions for how he/she can improve this?

Decision Making

  • Does not lose sight of the big picture when making decisions
  • Asks for additional information when making critical decisions.
  • Seeks input from key people who should be involved in, or will be affected by, decisions
  • Coaches team members individually when "poor" decisions are made; helps them see what could have been done differently
  • Breaks complex issues into manageable parts and organizes them in a systematic way before making decisions
If [Participant Name] were to make improvements in Decision Making, what are your suggestions for how he/she can improve this?


  • Sets a good example
  • Acts as a resource without removing individual responsibility.
  • Behavior is ethical and honest.
  • Sets a good example.
  • Responsible for setting the vision of the department.
If [Participant Name] were to make improvements in Responsible, 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.