Coworker Development - 360 Degree Feedback Survey Sample #9

360 Feedback Survey

Questionnaires Measuring Coworker Development:
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.

Sample Result Document:
Sample Results
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.

Co-worker Development

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

Continual Improvement

Definite Strength Meets Standards Needs Development N/A
  1. Looks for ways to improve work processes and procedures.
  1. Looks for ways to expand current job responsibilities.
  1. Open to the suggestions from others.
  1. Promotes training and development opportunities to enhance job performance.
  1. Searches for new methods, techniques, and processes that increase efficiency and reduce costs.


Definite Strength Meets Standards Needs Development N/A
  1. Is ready to offer help
  1. Sets an example for others to follow
  1. Makes you feel enthusiastic about your work
  1. Keep staff informed about what is happening in the company
  1. Takes responsibility for things that go wrong

Administrative Skill

Definite Strength Meets Standards Needs Development N/A
  1. Takes responsibility for decisions.
  1. Completes reports on-time.
  1. Accurately implements contract provisions.
  1. Has strong technical/computer skills.
  1. High attention to detail.

Decision Making

Definite Strength Meets Standards Needs Development N/A
  1. Does not lose sight of the big picture when making decisions
  1. Breaks complex issues into manageable parts and organizes them in a systematic way before making decisions
  1. Coaches team members individually when "poor" decisions are made; helps them see what could have been done differently
  1. Seeks input from key people who should be involved in, or will be affected by, decisions
  1. Assesses the risks, benefits, and potential impact of a number of options when deciding a course of action

Commitment To Result

Definite Strength Meets Standards Needs Development N/A
  1. Creates a sense of urgency among the store team members to complete activities, which drive sales.
  1. Maintains persistence and dedication to achieving results.
  1. Coordinates all department activities into a cohesive team effort.
  1. Able to focus on a task even when working alone.
  1. Committed to the team.


Definite Strength Meets Standards Needs Development N/A
  1. Sets a good example.
  1. Responsible for setting the vision of the department.
  1. Holds herself / himself accountable to goals / objectives
  1. Sets a good example
  1. Behavior is ethical and honest.


Definite Strength Meets Standards Needs Development N/A
  1. Encourages teamwork and collaboration.
  1. Recognizes and respects the contributions and needs of each individual.
  1. Act as an effective team player
  1. Creates a climate that encourages team participation.
  1. Coaches team members

Strategic Focus

Definite Strength Meets Standards Needs Development N/A
  1. Focuses attention on treating the causes of problems rather than simply addressing the symptoms.
  1. Understands their role within the organization.
  1. Understands & contributes to development of strategic goals.
  1. Able to decline a poor strategy by proposing alternate strategies.
  1. Monitors performance of each market within the Area, utilizing reports to ensure sales growth, cost management, and profitability targets are met.


Definite Strength Meets Standards Needs Development N/A
  1. Expresses the Company vision in a way that is easily understood and adopted by employees.
  1. Creates a positive vision of the future for the Company.
  1. Demonstrates consistency between words and actions
  1. Persuades others to follow the Company's vision.
  1. Behaves in a way that is consistent with business values & code of conduct

  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.