Excellence - 360 Degree Feedback Survey Sample #11

360 Feedback Survey

Questionnaires Measuring Excellence:
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.


What does Excellence mean?
It means that ...
  • You produce high quality work.
  • You demonstrate the functional or technical skills necessary to do your job.
  • You keep yourself and others focused on constant improvement.
  • You are planful and organized.
  • You demonstrate the analytical skills to do your job.

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

Bias for Action

What does Bias for Action mean?
It means that ...
  • You convey a sense of urgency about addressing problems and opportunities
  • You display high energy and enthusiasm on consistent basis.
  • You encourage risk taking and experimentation to improve performance
  • You identify ways to simplify work processes and reduce cycle times
  • You complete a large volume of work.

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


What does Attitude mean?
It means that ...
  • You build open and trusting relationships.
  • You contribute to a positive work environment.
  • You show by your actions that you trust in the positive intentions of others.
  • You work to eliminate unnecessary work or barriers that get in others' way.
  • You visibly support and encourages diversity in style and background.

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


What does Negotiation mean?
It means that ...
  • You establish good working relationships with others.
  • You are able to adapt to changing situations.
  • You actively listen to conversations to be able to recall important details later.
  • You resolve difficult negotiations whether it is a contract, sub contract, legal or any other difficult negotiation fairly and reasonably.
  • You are able to say "no" when necessary to effectively execute business strategy and meet long-term objectives.

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


What does Vision mean?
It means that ...
  • You clearly articulate a vision for your work and inspires others to support it
  • You demonstrate consistency between words and actions
  • You develop action plans to align your work with the goals of the organization
  • You lead employees in new directions.
  • You expresse the Company vision in a way that is easily understood and adopted by employees.

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

Areas for Development

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