Coworker Development - 360 Degree Feedback Survey Sample #10

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.

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

  • Takes immediate action on poor performance
  • Provides ongoing feedback to co-workers on their development progress
  • Sets and clearly communicates expectations, performance goals, and measurements to others
  • Adapts coaching and mentoring approach to meet the style or needs of individuals
  • Gives others development opportunities through project assignments and increased job responsibilities
If [Participant Name] were to make improvements in Co-worker Development, what are your suggestions for how he/she can improve this?

Problem Solving

  • Ability to solve problems at root cause rather than at symptom level.
  • Identifies and assesses all potential responses to a problem.
  • Able to balance the needs of different people in a solution to a problem.
  • Solves problems using logic and insight.
  • Effective in solving problems.
If [Participant Name] were to make improvements in Problem Solving, what are your suggestions for how he/she can improve this?

Conflict Management

  • Helps employees to think through alternative ways to resolve conflict situations.
  • Identifies and takes steps to prevent potential confrontations.
  • Clearly expresses expectations to others.
  • Assists team members by helping them see the other point of view.
  • Tries to understand others' point of view before making judgments
If [Participant Name] were to make improvements in Conflict Management, what are your suggestions for how he/she can improve this?

Organizational Fluency

  • Able to use corporate politics to advance department objectives.
  • Is aware of other organizational cultures to compare/contrast with the current organizational culture.
  • Able to explain departmental policies and procedures to others.
  • Effective in communicating with others within the organization.
  • Able to deal with sensitive issues with tact and professionalism.
If [Participant Name] were to make improvements in Organizational Fluency, what are your suggestions for how he/she can improve this?


  • Adds value to the department/organization.
  • Develops solutions to challenging problems.
  • Is creative and inspirational.
  • Inspires creativity in their team.
  • Creates a lot of new ideas.
If [Participant Name] were to make improvements in Creativity, 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.