Empowering Others - 360 Degree Feedback Survey Sample #11

360 Feedback Survey

Questionnaires Measuring Empowering Others:
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.

Empowering Others

What does Empowering Others mean?
It means that ...
  • You encourage employees to solve problems on your own.
  • You set clear goals for others to accomplish.
  • You avoid micromanaging your employees.
  • You allow individuals to be responsible for your decisions.
  • You distribute the workload to subordinates.

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

Supervisory Skills

What does Supervisory Skills mean?
It means that ...
  • You resolve personnel problems quickly and effectively.
  • You are aware of the unique strengths of each employee.
  • You encourage employees to achieve your full potential.
  • You treat all staff equitably.
  • You appropriately recognize and reward employees.

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

Results Oriented

What does Results Oriented mean?
It means that ...
  • You work toward achievement of goals even when confronted with obstacles.
  • You do not become distracted by non-issues or interruptions.
  • You encourage a high-energy, fun work environment and coaches others on how to do the same
  • You help others when free-time is available.
  • You explain the "whys" behind organizational objectives

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

Business Acumen

What does Business Acumen mean?
It means that ...
  • You effectively develop and use resources (people, time, money, supplies, equipment, and space) to improve organizational performance
  • You exhibit behavior that is consistent with the vision, mission, and core values of the organization
  • You are able to align resources to meet the business needs of the company.
  • You apply the knowledge of work processes to influence the achievement of business goals
  • You understand complex issues and problems.

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


What does Integrity mean?
It means that ...
  • You do what was promised.
  • You foster a high standard of ethics and integrity.
  • You accept responsibility for mistakes.
  • You demonstrate sincerity in actions with others.
  • You develop trust and confidence from others.

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

Areas for Development

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