Engagement- 360 Degree Feedback Survey Sample #12

360 Feedback Survey

Instructions

We appreciate you taking the time to provide valuable feedback for the individual mentioned above. As you respond, please draw on your first-hand experience with this individual in the past 12 months. Your insights are crucial in offering a comprehensive evaluation. Please rate each item using the scale provided. If you find that you do not have sufficient first-hand knowledge to rate a particular item, select the Not Applicable option.

In addition to the ratings, we encourage you to include comments where possible. These comments are particularly useful when you give a very high or very low rating, as they provide context and clarity regarding your assessment. Explaining your reasons in the comment section helps ensure that your feedback is constructive and actionable.

Your responses, combined with feedback from other contributors, will be compiled and presented to the individual. This collective feedback aims to support their continuous growth and development by highlighting strengths and identifying areas for improvement. Your thoughtful participation is essential in helping them achieve their full potential.

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.

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Engagement

• Supports career development and progression.
• Gives timely input that helps employees adjust their work before issues arise.
• Values the contributions that employees make toward the team's success.
• Keeps employees informed about what is going on at the company.
• Gives feedback that is specific and actionable, not vague or generic.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Communication Skills

• Shares important information with others.
• Delivers clear and concise instructions.
• Listens actively & speaks clearly and directly.
• Communicates with department leadership
• Keeps the supervisor informed about achievements and milestones.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Commitment To Result

• Improves customer satisfaction through building staff capabilities and strengthening their commitment to excellence.
• Recognizes and rewards commitment, highlighting employees who demonstrate dedication to goals.
• Able to focus on a task even when working alone.
• Actively engages each team member to ensure they personally endorse the initiative.
• Mobilizes individual commitment to the success of the department.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Employee Development

• Encourages junior managers to have a bigger role in company management.
• Conducts an assessment to determine what skills and knowledge need to be acquired by the employees.
• Encourages employees in the department to participate in training exercises.
• Uses promotions to recognize potential and provide opportunities for growth within the organization.
• Aligned cross-training initiatives with individual development plans to support long-term growth.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Teamwork

• Communicates a clear message that teamwork and collaboration are expected.
• Asks other team members to share their opinions.
• Shows respect for other team members.
• Helps the team make good decisions even under conditions of uncertainty.
• Creates a culture that fosters and values collaboration.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Strengths


Areas for Development


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